Howard Eisenson, MD: The Duke Diet & Fitness Center is unique in so many ways. We are, to the best of my knowledge, the only intensive, residential-style weight control and lifestyle change program that’s affiliated with an academic medical center.

We're very proud of the fact that we look beyond obesity. We really feel it’s part of our responsibility to educate folks in better self care, whether the issues are obesity, inactivity, diabetes, or high blood pressure. You name it, our goal is to help people take better care of themselves and to live life to their potential.

Of course, a centerpiece of our program is our nutritional plan. It’s really built around the idea that people should be planning their meals. They should have a calorie target in mind and know how to achieve that.

So one of the things we work at hard here is teach them how to estimate the calories in the meal and make better choices. We give them a host of strategies for being able to enjoy eating out and yet not exceeding their calorie budget for the day, including taking them out to eat and also taking them on a shopping experience at the grocery store where they learn how to make good choices there.

We truly live in an obesity-promoting environment, an environment where food is everywhere -- it’s not just available but we’re encouraged to consume it -- and a world in which ever less physical exertion is required of us.

Patient: I walked into the Diet & Fitness Center, and I said my life changed, and everyone says that -- you hear it on every talk show. But I’m alive. I was going to die. I would not be standing here at 35 years old today -- I would be dead. I have no doubt about it.

When you go to Duke, you think 30, 50, or 100 pounds, it’s such a big number. But one of the first things they explained to me was you’re just looking to lose a pound a week. If you lose a pound a week, you lose 50 pounds a year or whatever. And once I got that in my head -- and I learned it on the first day, that it’s a lifestyle not a diet and that you can lose a pound a week or two pounds a week and really affect your life dramatically -- everything made sense.

Eisenson: I think it’s really impossible to overstate the importance of exercise, of regular physical activity. People don’t appreciate how good it is for us. It’s essential not only for accomplishing weight loss but for keeping the weight off.

Many people who suffer from excess weight have mobility issues. Many of them have arthritis. And it’s so valuable to have a therapeutic pool.

We do provide a business-like environment, a place to get some serious work done, but we do want people to be comfortable. And we have some of your spa-style amentities like a great massage program.

Regular medical monitoring is a feature of our program. We do a comprehensive medical assessment when folks join us -- a history and medical exam. It’s not just about obesity -- we look at their health in broader terms than that. We try to look at what factors may have impeded their ability to practice better habits of eating and physical activity. We also help them to identify what stands to improve by adopting healthier habits.

We also see people at the end of this stay to summarize their progress on the program and to highlight for them those things that deserve their attention going forward. The role of the physician is critical at the Duke Diet & Fitness Center. Our medical staff is involved in every aspect of the program.

We work closely with specialists in nutrition, exercise physiology, and behavioral health. I’m proud of the fact that the program is never static -- it’s continually in evolution. We follow the latest science in our field, and we adapt our curriculum -- what we teach, the meals we serve, and the techniques we use with fitness instruction -- to deliver a program that’s medically sound, focused on the needs of the individual, and designed to improve health.