Frequently Asked Questions about the Duke Diet & Fitness Center

Below are answers to many of the questions frequently asked about the Diet & Fitness Center (DFC) and our programs.

General
Medical
Nutrition/Dietary
Fitness
Lifestyle Coaching/Behavioral Health
Financial/Insurance
Transportation/Lodging/Activities

General Questions

Who is right for the Duke Diet & Fitness Center program?

Adults age 18 and over at all levels of health and fitness come to the Diet & Fitness Center to lose weight, manage or prevent disease, and make healthy lifestyle changes. (Some adolescents age 16 or 17 are accepted into the program -- see next question.) Many come to maintain goals they have previously achieved or simply to rejuvenate themselves.

Do you have an adolescent program?

Our program is geared toward adults, but we sometimes admit adolescents as young as age 16 or 17 if they are accompanied by a legal guardian who also participates in the program. Admission of individuals this young requires approval from our medical director. Our educational program is adult oriented and may not be a good fit for the majority of adolescents.

Do you have weight limits?

We do not restrict admission based on weight, but you do have to be independently mobile or bring a personal aide for assistance at your own cost. Most of our clients range from being slightly overweight to significantly obese, based on the body mass index (BMI) scale.

Who is the Center’s staff?

The Diet & Fitness Center staff consists of experts in the treatment of obesity and related medical problems, including diabetes and cardiovascular disease. Professional staff members include physicians and other medical providers, exercise physiologists, massage therapists, physical therapists, registered dietitians, behavioral specialists, health coaches, and psychologists. All are caring and dedicated to helping you achieve your goals.

How are you different from other weight loss programs?

At the Diet & Fitness Center, we focus on making lifestyle changes rather than losing weight through dieting. You will be working with a team of experts in the fields of nutrition, health management, fitness, and behavioral health who will help you develop your complete lifestyle plan. Their role is to help you create an individualized plan that will meet your long-term needs.

What is a typical day at the Diet & Fitness Center?

A typical day includes educational classes, meals, and exercise. In addition, you may be scheduled for individual sessions with staff. Social and recreational activities are available most evenings. A sample schedule is included in your inquiry packet. Download a sample of evening activities (PDF, 29 KB).

What is the recommended stay for a first-time client? Is there a limit to how long I can stay?

We highly recommend a four-week stay for your first visit to the Diet & Fitness Center (DFC). Four weeks provides enough time to begin establishing healthier eating and exercise patterns, see improvements in many medical conditions, and learn strategies to identify and overcome emotional and behavioral issues that may impact your efforts to adopt a healthier lifestyle. Our core program runs on a four-week cycle, so you will enjoy new classes and activities throughout your stay.

Because we realize it is not always possible to get away for four weeks, we also offer two- and three-week options that are more condensed versions of the four-week program and focus more on education than experience. For clients who absolutely cannot get away for more than a week, we offer a five-day intensive evaluation and planning program that enables you to begin addressing the risks of excess weight and insufficient physical activity with a thorough, individualized evaluation and treatment recommendations from our nutrition, fitness, behavioral health and lifestyle, and medical experts.

The DFC advocates a practical approach to healthier living and weight management that you can live with for the rest of your life. While it is very beneficial to begin this journey in the controlled, supportive environment of the Center, we believe it is important to practice these new habits and strategies in the real world. Therefore, we encourage new clients to stay at the DFC for no more than 12 weeks at a time. Stays beyond 12 weeks must be approved on a case-by-case basis by the treatment team. Clients are encouraged to return to the DFC periodically to refocus or reenergize, to continue working on existing issues, and to address new issues as they arise.

What is the average weight loss that I can expect to achieve while enrolled?

On average, Diet & Fitness Center clients lose approximately 1 to 1.5 percent of total body weight per week. This is not a quick fix; however, research shows that this moderate level of weight loss is more maintainable over the long term. Each individual’s weight loss will vary depending on many factors.

Can I bring a friend or family member to support me? In which activities can my support person participate?

It can be very helpful to have a friend or loved one with you at the Diet & Fitness Center (DFC) to provide support and to help him or her gain an understanding of the lifestyle change efforts you will be implementing when you return home. The DFC’s Support Program enables you to bring a close friend or adult family member who does not struggle with weight themselves.

Support clients may attend lectures (excluding discussion groups) and eat all meals at the DFC. Support clients who are not at increased risk for adverse events during exercise may use the gym and pool. (Individuals at increased risk for adverse events during exercise will be required to have had an exercise tolerance test within the last 12 months that has been interpreted as normal as a condition for using the DFC’s exercise facilities.) Learn more about our Support Program

How far in advance do I need to make reservations? What do you require at the time of reservation?

To secure your preferred reservation date, we recommend that you book your stay three to four weeks prior to arrival. To reserve your space, you will need to submit a completed application.

Do you offer tours of the facility?

If you will be in Durham, we would be happy to show you around the facility. Please contact our Admissions Office in advance to arrange a tour.

Are you affiliated with Duke University?

Yes. The Diet & Fitness Center is a program of the Duke University Health System.

Can I enroll a friend or family member without their permission, or do they have to complete the application?

Because the Diet & Fitness Center is an intensive treatment program that requires a personal commitment to lifestyle change, each client must enroll in the program of his or her own volition. Our application process also requires detailed personal and medical information that can only be completed by the person enrolling in the program. Friends and family members can offer valuable support; however, lifestyle change is a very personal process that requires an individual’s consent and buy-in.

Do you offer spa-type services, such as massage therapy, saunas, facials, etc.? Are there alternative medicine programs that I can attend while at the Diet & Fitness Center?

We offer massage therapy and personal training on-site for an additional fee. We also have separate whirlpools, saunas, and steam rooms for men and women. For manicures, hair cuts, facials, and other specialty services, we can provide a list of local facilities.

One of our sister programs, Duke Integrative Medicine, offers a variety of full-day or half-day immersion packages and a la carte services that are available to Diet & Fitness Center (DFC) clients for an additional fee. The DFC treatment team and client relations staff can help you identify the most appropriate services -- which may include acupuncture, polarity therapy, Reiki, and spiritual counseling -- and the most effective way to use these to complement your DFC visit. (Note: Duke Integrative Medicine collects payment directly for their services.)

How often will I meet with a counselor?

When you enter the Diet & Fitness Center program, you receive individual medical, nutrition, behavioral health, and fitness assessments. Following the assessments, clients may schedule a weekly check-in with professional staff. Many clients elect to get additional counseling (for a fee) during their stay.

Do you have any satellite programs in other areas?

We do not have any satellite programs at this time.

Do you offer weekend services?

During your DFC experience, our team of experts will guide you through a variety of health options to practice on the weekends. Your weekend plan may include DFC meals “to-go”, meal replacements, local hotel dining, chain restaurants in the local Durham area, and more! Plus, continue your exercise program at nearby fitness centers, including the Duke Health and Fitness Center, just minutes from the DFC, or enjoy outside activities, such as walking the beautiful Duke campus or other local trails. Effective January 11, 2014, the DFC facility will be open from 8am to 4pm on Saturdays. We will be offering a fitness class in the gym for those clients who have their exercise clearance. We will continue to offer the option to purchase your weekend meals in advance. We are happy to store your Saturday breakfast and lunch at the DFC so that you can enjoy them in the dining room together.

Medical Questions

Are there certain medical conditions that cannot be accommodated at the Diet & Fitness Center?

We are unable to provide individual assistance for activities of daily living, so if you are unable to care of yourself you will need to bring an attendant. However, there are few medical conditions that we are unable to accommodate. For example, we are able to care for clients who are dependent on oxygen and those dependent on motorized scooters. If you are incontinent, of course, you’ll be unable to use the pool. If you are recovering from recent surgery, we recommend that you complete your recovery before coming to the Diet & Fitness Center.

Can you accommodate people with disabilities? Do you provide assistance?

The Diet & Fitness Center can make some accommodations for clients with disabilities. Most areas of the building are wheelchair accessible. If needed, we recommend that you bring an aide for mobility assistance at your own expense, as we are not able to provide these services. Please ask our admissions representatives about accommodating any special needs.

Do you only take clients who have medical conditions?

No, we have a number of clients who have been fortunate enough to avoid obesity-related illnesses but still benefit greatly from participating in the Diet & Fitness Center program.

What type of medical oversight is provided?

The Diet & Fitness Center medical clinic is staffed by physicians and nurse practitioners. One of our physicians is also on call 24 hours a day, and our clients have access to the full array of medical services that a major health system like Duke has available. All clients undergo an extensive initial medical assessment and laboratory testing, and an additional medical assessment at the completion of the program. In addition, clients are seen weekly in the clinic for weight and blood pressure checks and brief medical visits. All clients are free to make appointments with our medical practitioners at their convenience.

In addition, many clients come to Duke for opinions from Duke medical specialists, and we assist in arranging those specialty appointments. If you are interested in seeing a Duke specialist during your stay, please note this on your application or let our admissions representatives know in advance of your arrival so we can do our best to accommodate you. We have physical therapy and massage therapy on-site, and our clients have ready access to a variety of other complementary and alternative medicine treatments such as Reiki, acupuncture, meditation, or chiropractics.

What is included in the Diet & Fitness Center’s medical assessment?

The initial medical assessment includes:

  • A very thorough history to assess not only your medical conditions but also your weight concerns
  • A physical exam
  • Lab tests, including fasting glucose, liver and kidney function, thyroid function, fasting lipids, hemoglobin, electrolytes, and blood proteins

A special lecture will explain these results. Through the Duke clinical lab, we can perform virtually any test that can be done, although there is an extra charge for any additional tests.

If I have a medical condition, do I need my physician to refer me to the program?

No, a referral is unnecessary, though we often request copies of medical records from home to complete our medical evaluation.

Are you able to accommodate clients who are on insulin pumps?

Yes, though it is the client’s responsibility to arrange for and purchase pump-related equipment.

Do you offer a special curriculum for clients with diabetes? Can you help me achieve better control of my diabetes?

About 50 percent of Diet & Fitness Center (DFC) clients have either prediabetes or diabetes, so we have extensive experience treating this disease. We have a medical staff that is experienced in treating diabetes, and we also provide diabetes education. Our staff works together to provide comprehensive, individualized care for our clients with diabetes. We offer lectures on the causes, concerns, and management of both diabetes and prediabetes, along with free glucometers and intensive day-to-day management of diabetes, as needed.

Almost all of our diabetic clients experience much improved control of their diabetes during their DFC stay. However, in the very rare instance where the DFC diabetes treatment staff is unable to obtain good control a client’s diabetes, we can consult with, or refer clients to, our colleagues in Duke’s outstanding endocrinology division.

I am interested in gastric bypass surgery. Do you admit clients who plan to have this type of surgery? Can I come to the program after having gastric bypass surgery?

Like most obesity experts, we believe that for some people, surgery can be a valuable tool to treat obesity. For individuals with severe obesity who are medically compromised, and for whom the results of lifestyle change efforts have been insufficient, surgery may indeed be the most appropriate option.

The best short- and long-term surgical outcomes usually occur when the patient has achieved some degree of weight loss and physical conditioning prior to surgery, and when he or she is able to maintain a healthy lifestyle after surgery. Therefore, we routinely have clients on the Diet & Fitness Center program who are preparing themselves for possible surgery, and others who have already had surgery and are engaged with us to optimize their long-term results.

Our dietitians work with pre- and post-surgical patients to customize their dietary program and meet their individual needs. In the post-surgical phase, we will provide a meal plan that is easy to tolerate and rich in nutrients. Post-surgical patients have the option of eating six small meals per day.

Can you refer me to specialists at Duke while I'm enrolled in the program?

Yes. We frequently refer Diet & Fitness Center clients to our Duke colleagues in other specialties. Many of our clients come to Duke for second (or even first) opinions about their medical conditions. However, some medical specialties at Duke may infrequently experience long waiting lists that can preclude ready access. If you are interested in seeing a Duke specialist during your stay, please note this on your application or let our admissions representatives know in advance of your arrival so we can do our best to accommodate you.

What types of medical classes do you offer?

Our medical experts offer weekly lectures on management of diabetes and prediabetes, hypertension, depression, preventative medicine, obesity surgery, and other topics relevant to our clientele. Our medical lecture series is continually updated to reflect topics of interest and the latest scientific research.

Nutrition/Dietary Questions

I follow a special diet due to health, religious, or personal reasons. Can you accommodate my dietary requirements?

Yes, we can make accommodations. We provide a list of all the ingredients we use in recipe preparation, which highlights common allergens such as gluten, wheat, nuts, dairy, and shellfish. We also provide vegetarian options at each meal, and we can make some accommodations for kosher clients. If you have food allergies or other restrictions, please mention them during the registration process so we can be sure we can meet your needs.

What nutrition plans does the Diet & Fitness Center offer?

The Diet & Fitness Center (DFC) offers a variety of healthy nutrition plans. Our dieticians work with each client to determine their individual needs and interests and to choose a plan that will work best. The DFC offers a traditional low-fat plan, a very-low-carbohydrate plan, and a moderate-carbohydrate plan. Each focuses on healthy, balanced nutrition principles, healthy fats, and a sustainable approach to eating that leaves you feeling satisfied and not deprived.

Do you offer cooking classes as part of your core program?

Because cooking skills play an important role in healthy eating and lifestyle change, we offer at least one cooking class per week. These classes, led by our experienced and health-conscious chefs, teach clients basic skills needed to prepare healthy, deliciously tasty foods when you return home. We also offer private cooking classes for individuals or small groups. These hands-on classes, available for an additional fee, are customized to your interests and skill level, so they're perfect whether you're new to the kitchen or an accomplished cook.

What types of nutrition classes do you offer?

Our core nutrition program focuses on proper meal planning, calorie and portion control, and prevention of heart disease through diet, with additional classes on everything from popular diets to mindless eating. We also offer a virtual grocery store tour and healthy dining out classes. Private grocery store tours with a registered dietitian (for an additional fee) may be beneficial for clients who frequently shop in specialty grocery stores, who seek a more in-depth experience than our weekly group grocery store tour, or who have special dietary interests. Our nutrition program is continually updated to reflect topics of interest and the latest research.

Fitness Questions

What exercise options does the Center have?

Our comprehensive fitness program includes a fully equipped gym with four TVs, allowing you to watch programs while working out on our treadmills, elliptical machines, recumbent bikes, NuSteps (recumbent steppers), and more. We also have free weights, weight circuit machines, and a separate Pilates studio. Our aerobics floor hosts group classes targeted to every fitness level from step aerobics, kick-boxing, and spinning (indoor cycling) to group strength classes. The Mind/Body Room provides a quiet space for classes such as yoga and Pilates. We also have a pool (see next question).

Before you begin exercising, you will undergo a comprehensive medical assessment (including a stress test, if deemed necessary). Then, you will meet one-on-one with a Diet & Fitness Center (DFC) exercise physiologist to develop a personalized plan that meets your individual needs, interests, and fitness level. The DFC fitness staff is available during your stay to help you adjust your plan as needed.

Throughout your program, classroom lectures will educate you on fitness fundamentals, injury prevention, self-care, and other topics. And just before you leave the DFC, the staff will work with you to develop your own fitness plan for when you return home.

Clients can also sign up for up to three personal training sessions per week with the DFC fitness staff, for an additional fee. We also offer body fat/composition testing using state-of-the-art BodPod® air displacement technology, for an additional fee.

Does the Center have a pool?

Yes. Our beautiful glass-enclosed, privacy-conscious pool has both shallow and deep ends for water aerobics, strength and stretch classes, water walking, and lap swimming. During nice weather, cross-vents and a partially opening roof let in a gentle North Carolina breeze and give the feel of an outdoor pool. An enclosed, temperature-controlled walkway makes a comfortable transition directly from the locker rooms. The pool, like our whirlpools, is cleaned with an innovative salt system that reduces the odor of chlorine and is gentle on your skin.

Can I start exercising as soon as I arrive at the Center?

No. To ensure safety, each new client must undergo a comprehensive medical assessment prior to exercising. If you have certain cardiovascular risk factors, you may be required to take a stress test (at an additional fee) before exercising. Once you have been cleared for exercise, you will meet one-on-one with a DFC exercise physiologist to develop a personalized exercise plan. Then you'll be ready to take advantage of our extensive offerings in the gym and the pool, where you'll find appropriate options for every fitness level.

I have joint and mobility problems. How can your program help?

Many Diet & Fitness Center DFC clients have joint and mobility problems caused, or exacerbated, by excess weight. Our pool classes and workouts in the water can be especially beneficial, enabling you to exercise while minimizing impact on your joints. The DFC gym also features several types of low-impact cardio equipment, including recumbent bikes and Nu-Step recumbent step machines, that minimize strain on your joints. A DFC fitness expert will work with you to develop a plan that enables you to exercise without pain -- and you'll be amazed how much better you feel in just a few weeks!

What types of fitness classes does the Center offer?

The Diet & Fitness Center staff presents frequent classroom lectures on topics such as fitness fundamentals, staying motivated, injury prevention, and overcoming fitness barriers. These classes are continually updated to reflect clients' interests and the latest research. We also offer a wide range of fitness classes in the gym and pool. No matter your fitness level, there's a cardio class for you, from step aerobics, cardio circuit, and indoor cycling, to chair aerobics and shallow and deep water aerobics. You can also take part in strength training and stretching group classes in the gym and pool; as well as t'ai chi; Pilates; yoga performed on mats and in chairs; and healthy back, posture, and balance classes. For clients at more advanced fitness levels, we also offer boot camps in the gym and pool.

BEHAVIORAL Health Questions

What type of support do you offer clients after they return home?

The Diet & Fitness Center (DFC) program doesn't end when you leave the Center. A healthy lifestyle is a long-term commitment, and the DFC is here to help you after you return home. Throughout the DFC stay, clients take part in several action-oriented classes designed to help you develop a realistic plan to keep you moving toward your goals when you return home. Clients can also meet one-on-one with behavioral health clinicians to discuss individual challenges and plan for future success.

In addition, the DFC staff hosts free group follow-up phone calls every week just for DFC alumni. Many DFC clients also plan to return to the DFC periodically (often with the friends they've made here) to reenergize, refocus, stay or get back on track, or plan the next phase of their healthy lifestyle journey.

What is the Personal Lifestyle Coaching Program?

The behavioral health clinicians can also provide personal lifestyle coaching over the phone when you return home. This will provide you with additional support, problem solving, goal setting, and accountability as you continue and work on healthy lifestyle changes. 

Does your program treat bulimia and anorexia? Will you accept clients with binge eating disorders in your program?

Clients with bulimia, anorexia, or severe eating disorders are not accepted into the program. We do provide treatment for binge eating disorders.

What types of behavioral health classes do you offer?

Diet & Fitness Center (DFC) behavioral health experts present regular classroom lectures that address challenges and topics familiar to many DFC clients, including stress management, emotional eating, realistic goals setting, action planning, mindfulness, and social support. We also moderate smaller group discussions that enable clients to go into greater depth on topics such as emotional eating.

We continually update our behavioral health classes to reflect topics of interest and the latest research.

Financial/Insurance Questions

What is included in the program fee?

The Diet & Fitness Center program fee includes meals, Monday - Friday, all educational classes, scheduled exercise sessions. Also included are individual assessments, and weekly check-ins with members of the Duke Diet & Fitness Center's professional staff (e.g. physician, nurse practitioner registered dietician, etc.). New clients receive a complimentary personal training session.

You may elect to have additional services such as personal training, psychotherapy, lifestyle coaching, or therapeutic massage at an additional cost. Additional medical consultations will be an additional cost. Please bring your insurance card in the event that you are referred to other Duke specialists.

Will my health insurance cover any of the Center's fees? Do you accept Medicaid or Medicare?

Obesity treatment is outside the scope of what most insurance providers consider traditional levels of medical service and may not be covered by insurance. The Diet & Fitness Center (DFC) does not participate in any insurance agreements or managed care contracts (except Medicare), and therefore does not file insurance claims except in cases where Medicare applies. In cases where Medicare does apply, only a small portion of the program will be billable to Medicare. The balance must be paid in full at the time of your visit. Payment in full is expected for all non-Medicare clients at the time of your visit.

Do the program fees qualify as a medical tax deduction?

Weight loss programs may be tax deductible when prescribed by your physician to treat obesity. Consult with your tax advisor to determine if the fees are tax deductible.

Transportation/Lodging/Activities Questions

How do I get to the Diet & Fitness Center?

The Diet & Fitness Center is located adjacent to the Duke University campus at 501 Douglas Street in Durham, NC, 27705. The closest airport is Raleigh/Durham International Airport, located approximately 15 miles from the center. See our Travel & Accommodations and Locations pages on dukedietcenter.org for more information and directions.

Where do most people live while visiting the Center?

While we do not offer on-site accommodations, we work closely with several nearby hotels and lodging facilities that provide convenient, comfortable accommodations for our clients. Several offer special rates for Diet & Fitness Center clients. For the latest housing options, please feel free to contact our admissions representatives with questions.

Will I need a car during my stay? Does the Diet & Fitness Center provide transportation to the program each day?

Clients are responsible for their own transportation to and from the Diet & Fitness Center (DFC) each day. We do recommend that you either bring your car or rent one during your stay. Durham has several walkable areas. However, it helps to have a car since there is only a limited mass transit system. Many clients enjoy the flexibility of sightseeing and visiting the local attractions on the weekends.

Several lodging facilities offer shuttle services -- see Housing Options guide (PDF). The DFC does offer van service for clients who need to go to the Duke Center for Living for tests or medically supervised exercise. 

Are there lodging facilities that allow pets?

Yes. While the Diet & Fitness Center does not allow pets on our campus, several lodging facilities do allow pets. Please contact the facilities on our Housing Options guide (PDF) to ask about their pet policies and fees, as details may change.

Is there child care available, or a place where my children can go while I'm at the DFC?

If at all possible, we strongly encourage you to make alternate plans rather than bring your child with you when you attend the Diet & Fitness Center (DFC) program. This is an important time to focus on yourself and your health, and you will be very busy with classes and activities.

Children under age 15 are not allowed to use the DFC gym or pool or attend classes. While on the DFC campus, all minors must be supervised by a family member or guardian. If you absolutely must bring a child with you to Durham, our admissions representatives may be able to help steer you toward some child care options.

I will still need to do business while I am at the Center. What free time will I have to conduct my business?

While we understand your need to keep your professional obligations, we encourage you to stay focused on the program during your stay. Every weekday is full with structured educational and fitness activities. However, you will have free time late in the evening on weekdays and on the weekends, and perhaps time during the day. For your convenience, the Diet & Fitness Center provides a bank of Internet-connected computers and private telephone/work areas to keep in touch with your family, friends, or office, as well as wireless Internet capability throughout the facility.

Do you have Internet access available at the Diet & Fitness Center?

Our entire facility has wireless (Wi-Fi) Internet access. We have several Internet-connected computers available at the Diet & Fitness Center for your use on a limited basis. It has been our experience that it is best to bring your own laptop computer if you expect to conduct business or access the Internet more frequently. We have several private rooms with phones and laptop connections that you can use to make calls or conduct business. Many lodging facilities provide in-room Internet access, but sometimes at a fee. Please check directly with your lodging facility.

What activities are planned in the evening following dinner?

We have an activity coordinator who schedules evening outings Monday through Friday for clients. However, we are not able to provide transportation.  Clients often carpool to local events.  Some examples of activities include sporting events (baseball, hockey, football), a local museum, shopping, and live performances. We also have activities on-site such as special lectures, movies, and bingo. We try to plan activities that are geared around clients' special interests.

Are shopping facilities nearby?

Brightleaf Square, a small boutique-type shopping center, and Ninth Street, with its small-town Main Street feel, are both short drives from the DFC. Several other larger shopping centers are located within a 20-minute drive. 

LEARN MORE: For more information or to speak to an admissions coordinator, call 1-888-313-7174 or use our online contact form.