A record 43 million people are now seriously obese in this country. And while overeating may seem to be an addiction, so is dieting.
And to confuse things even more, countless studies show that 95 percent of all dieters eventually re-gain all the weight they lost.
"Fat City," as Correspondent Morley Safer first reported in Jan. 2002, may be their last resort. While there may be nothing funny about fat, the dieters call Fat City the "Lourdes of Lard." But the city is better known as Durham, N.C.
Durham used to be the capital of Big Tobacco, but as tobacco moved to cheaper, greener pastures, the weight-loss industry moved in.
The industry produces a financial gain of about $80 million a year, making Durham the quiet diet capital of the world. There are three major clinics, not pampering fat farms, but medically supervised, no-nonsense establishments with very strict regimens.
Thousands come annually, and they lose about 100 tons a year – about the same weight as the fully loaded planes they ride in on.
"Durham is Ground Zero for weight loss. If you can't lose weight in Durham, you can't lose weight," says author Jean Renfro, who came here 13 years ago and lost 100 pounds. She was so taken by the power of Durham's diet culture, and the way it lives off the fat of the land, that she decided to stay and build a career.
She's now an anthropologist who specializes in fat. Why fat? "Well, No. 1, I am fat," says Renfro. "And I thought I would study my own culture. Why go somewhere else when I can do it right here at home?"
Renfro has written a book called "Fat Like Us," which gives some idea how desperate people can be. They can lay out anywhere between $3,000 and $8,000 a month to take off the pounds.
"People sell everything to get here. They sell their cars, their homes, everything they own," says Renfro. "Cash in any savings just for the opportunity to lose weight in Durham."
It started in the '40s, when Dr. Walter Kempner at Duke University proclaimed that a strict diet of fruit and rice not only kept diabetes and high blood pressure under control, but led to enormous weight loss.
The rice diet put Durham on the map, and celebrities who were had experienced so much weight gain - such as Shelley Winters, Buddy Hackett, James Coco, Col. Sanders - all headed south.
"I would watch some ex-fattie on TV talk about how they lost all their weight in Durham," says Renfro. "And I remember, as a small child, eating potato chips and watching that and thinking, 'I will be that.' I will be in Durham one day."
And she was. She spent months on the rice diet. Over the years, two more serious diet programs were established in Durham. At the Duke Diet & Fitness Center, Pennsylvania high school football coach Michael Mischler, and Charlie Beech, who came from Venezuela, had both reached critical mass.
"I remember when I hit 300, it was, 'Wow -- 300 pounds -- only the fattest people on earth are 300 pounds.' Well, now I'm 400," says Mischler.
"It's just really poor eating habits. I mean, you're going home, wife's trying to help you out by cooking a healthy meal. I call her up and I say, 'What are we having for dinner?' "Well, you know, I'm having some chicken and rice." I'm like, 'All right, well, I'll stop at McDonald's on the way home and get a value meal.'"
That little pre-dinner snack had about 1,800 calories. At Duke, Mischler is allowed only 1,650 calories for the entire day. They're also taking classes on how to shop in the supermarket, and they have to undergo a form of dietary torture: eating just one slice of pizza.
"They teach you to eat the first part slowly, and then the second half, they ask you to cram it down your face," says Mischler. "When I had my second half, it kind of reminded me of the way I used to eat."
There's no secret potion, just a simple rule: eat less, move more. The payoff? In eight weeks, Beech lost 46 pounds. And in four weeks, Mischler lost 29.
Both feel it's just a beginning, but they say they couldn't have done it on their own.
"If it was that easy, more than half of America wouldn't be obese at this point in time," says Mischler. "I mean, it's not that easy. And I needed to get away from my environment."
That's the most common theme you hear. And retired Chicago lawyer Evette Zells says the only place where she can lose weight, and keep it off, is in Durham.
"I'm building my life around that fact I bought a small house here, and in order to control it for the rest of my life, I will have to spend probably several months, or more, here every year," says Zells.
Zells has been working out at the Duke Center for Living, and she's lost 140 pounds. This time, she's a veteran at taking it off and putting it back, because she's been doing it for 40 years.
She admits there is something almost addictive about this place. "When you're here, you're away from everything at home. You're away from your family. You're away from the pressures," says Zells. "There's no one here to tell me that I can't be in the gym for three hours every day. There's no one here telling me, 'Let's go out and have pizza.'"
Dieters say the Durham experience is addictive, because of the sense of community a fat person feels here.
Renfro says it's like a religious experience because there is nothing like weight loss to transform a fat person's life: "You really come alive here. You really become yourself here. Where at home, you're somebody's wife, you're somebody's mother, somebody's daughter. But in Durham, you're whatever you're going to be."
"Is it like a religion in that sense, that you want to be near the cathedral, you want to be near the Lourdes," asks Safer.
"Yes, of course. And it has to be. To be really effective in weight loss, you have to incorporate it as a religion," says Renfro.
She says religious references abound in the weight loss culture. The local strip of fast food restaurants is called "Sin City," and before they start the program, many indulge in "The Last Supper."
Marianne Dorfman remembers her last supper well, and she and her friend, Gloria Sayles, say Sin City is a constant temptation. Has either one of them ever slipped away for a quiet burger?
"No. Fortunately, we went out as a group and we were there for each other," says Sayles. "I won't say we weren't tempted. As a matter of fact, everywhere, cheesecake, you know, it was calling us. ...But when we were weak, then fortunately the other person was strong."
The common goal of becoming "un-fat" does form strong bonds -- they eat, live and work together, and together, they learn to understand their weakness.
"One of the workshops told me that I have to learn to love this overeater," says Dorfman. "Well, I said, 'Love it? I wanna kill it, here's the gun. I want to kill it.'"
But there is no magic bullet, says Dr. Gerard Musante, director of the Structure House Diet Center. "People want quick fixes. And perhaps it's our society has gotten to feel that things can be done easily," says Musante. "Life isn't like that. This is a long-term problem."
Across town at the Duke Rice Diet, some people are battling matters of life and death. Marilyn Brill, whose weight brought on congestive heart failure, says she tried everything before coming to Durham.
"I've been to Dr. Atkins himself, and Dr. Lynn, and my husband thinks Weight Watchers is charity that we contribute to every year," says Brill. "But besides that, I came here -- I was really sick. I literally couldn't walk from the door to a table."
Kevin Brown also checked himself into Rice, because at only 31, he feared his obesity might soon cost him his life. Just 13 years ago, after graduating from high school, he was a trim 240 pounds.
"When I first came to the Rice Diet two weeks ago, I weighed 604 pounds," says Brown. "I've lost 43 pounds so far. I want to get down to healthy, probably around 230 to 250 would be healthy for me, because I'm a big guy."
He thinks this may be possible, because there are success stories from the Duke Rice Diet that have done just that. Success stories like John Illg, an Iowa farmer who came to Rice a year ago, weighing 651 pounds. Since then, he's lost 365 pounds – a pound a day.
Now weighing in at 282, he says he's ready to face the world: "When I saw Kevin Walk in the door, I saw myself a year ago. That's what I saw."
"I'm hoping I see myself in a year looking like John," says Brown, who will need to exercise, eat and get weighed, along with other Ricers.
They'll also have to eat the same bland fruit and grain, day after day. But just around the corner, Sin City still beckons.
"If you're window shopping, the temptation's there," says Brown. "But, you know, at 604 pounds, I realize that that's life-threatening."
"I am going to have it all off. I'm gonna be gorgeous as I used to be and very strong," says Brill. "And if Oprah's ready to give up her show, maybe I'll be over there. But I'll keep my weight off."
The ability to laugh at oneself is another common theme in Durham.
"If we lived in Japan, we'd be sex symbols," says Beech.
"I use humor as a defense mechanism where I'm trying to say, 'Listen, I know you know I'm fat, but that's OK, and I'm gonna joke about it," says Mischler.
Joking aside, how are the dieters 60 Minutes met doing now – nearly three years later? The results are mixed.
Mike Mischler initially lost more than 100 pounds, put it all back on, gave up on dieting and opted for surgery to reduce his stomach size. He has now lost over 100 pounds once again.
Charlie Beech succeeded at first, but then put it all back on and also opted for surgery. Marilyn Brill kept to her regimen and has lost 95 pounds. John Illg has lost another 75 pounds, for a total of 440 pounds.
And Kevin Brown? Sad to say he has given up on all programs. He now weighs 605 pounds.