By Gerard J. Musante, Ph.D., ABPP, Founder of Structure House Weight Management

Earlier this year, the editors at Health magazine created a panel of experts who reviewed more than 60 diet programs and selected the top 10 healthiest. Structure House was ranked as the number-one program for weight loss, beating other, more well-known, options such as Weight Watchers, EatingWell Diet, The Best Life Diet, You: On a Diet, and the Sonoma Diet.

Probably a question I have been asked almost more than any other is, how did I get so involved in weight management? The program has an interesting beginning that stemmed from what I believed was the need for a well-rounded approach to weight loss. However, I was cautioned against going into the field of weight loss. As a behavioral psychologist, this didn’t appear to be a viable career move in the early 1970s.

I began my career working at a major medical center in Durham, North Carolina and saw a significant need for weight loss treatment. Back then, treatment options were inadequate, consisting of very low calorie diets or fasting diets that often didn’t incorporate exercise or nutrition. Health care professionals ignored the problem and abandoned the idea that something could be done for overweight and obese people. It was typical for a primary care physician to work up a patient and completely ignore the cause of several of his or her health problems: obesity. Sadly, many nurses and doctors continue to struggle when addressing weight loss with patients.

Once I began working with patients, I realized much more needed to be done. I enjoyed talking with my patients, and many times this led them to their opening up about their problems with overeating. I wanted people to feel comfortable enough to talk freely about their relationships with food. I wanted to offer my patients an option for weight loss and believed lifelong weight loss depended on a lifestyle change. To me, this was a perfect fit for a behavioral psychologist.

In the early 1970s, there was very little research done on weight loss programs and it was generally thought that patients with this problem could not be helped. I shared my ideas about counseling overweight patients and was discouraged by colleagues and friends. They believed I would lose credibility if I moved in the direction of weight loss.

I believed differently. I envisioned a residential environment where participants could engage in a variety of experiences under the nurturing guidance of a caring and knowledgeable staff. In 1971, I began planning and incorporating new options for overweight patients that directly addressed weight loss. I became known within the medical center as someone who would work with those dubbed as “difficult” patients and enjoyed frequent breakthroughs with people who had never attempted behavioral change to affect weight loss.

I soon realized I was limited to what I could do at the medical center and needed to branch out on my own. In 1977, I opened a center for weight control and lifestyle change, naming it Structure House to underscore the critical role structure plays in achieving long-term weight loss.

When Structure House was first established, it consisted of an old elegant house in downtown Durham where participants would go for breakfast. The original 16 participants lived in nearby hotels. At this time, a nutritionist and I were the only staff members. I spent the next few years building a team that shared my same beliefs and lifestyle approach for healthy eating; many of whom are still on staff today.

In 1986, Structure House expanded to its current facility that was designed and built specifically for a true residential weight loss program. I strongly believed this type of immersion was essential to the program’s success. Immersion programs have long been used and proven successful for treatment of addictive behaviors as well as a host of psychological and psychiatric problems but had never been applied to obesity treatment. In order to change a person’s behavior, they must break old habits and learn a new way of living. This is best done in a residential, immersion program.

We have found that overweight individuals need to be in a very safe environment in order to open up and share their feelings. This is critical in determining why food is abused. We developed and designed the Structure House facility solely for this purpose. The campus is user-friendly for people who are immobile and those who are particularly overweight. The large-scale rooms help people feel comfortable.

Once a participant is on campus, we completely immerse them in a healthy living environment, which is more likely to build confidence they can continue treatment after returning home. Through one-on-one and group classes, we show each person what their specific relationship with food is all about. We delve into why they developed that relationship with food, how they make use of food, and ways to correct unhealthy behaviors and habits.

At Structure House, we recognize that any individual who comes here has developed some kind of dysfunctional relationship with food. All relationships with people are different and it's the same way with food. Some people use food to fill their time, other people use food to deal with stressors in their lives; others use food to deal with positive emotions. Once these issues are exposed, then the concept of using structure is introduced to help people lose weight and keep it off.

During the past three decades, our efforts have come full circle. Today, Structure House typically serves more than 70 participants a week at our 20-acre residential facility. Our staff members specialize in a broad variety of areas including psychology, diabetes, post-surgery assistance, pain management, binge eating, nutrition and fitness.

Thirty years ago, no one connected lifestyle change with obesity treatment. Today, it is widely accepted that obesity could be approached from a behavioral standpoint and the Structure House approach has influenced a number of weight loss programs.

Researchers from around the world have traveled to Structure House to learn about obesity through our unique evidence-based research program. For several years, Structure House has been a regular presenter at the annual conference of NAASO, The Obesity Society. A sampling of recent NAASO posters from Structure House treatment staff include, “Reflective Self-Monitoring: Weight Loss from the Inside/Out,” “The Skinny on Super Losers,” and “Weight and Behavior Change in Older Obese Adults Seeking Residential Obesity Treatment.”

With each passing year, we are developing more programs to help people stay “Structured for Life” and provide the tools needed to maintain a new healthy lifestyle.

If you’re interested in more information about Structure House Weight Management, please contact us at www.structurehouse.com.

Renowned clinical psychologist, Gerard J. Musante, Ph.D. founded Structure House in 1977 and understands firsthand the struggle faced by overweight people. He has devoted his professional life to developing and teaching the principles of behavior modification. Today, his internationally respected weight control program, Structure House, has helped more than 30,000 people change their attitudes, perceptions and lifestyles with diet, exercise and education. Structure House is a residential center for weight control and lifestyle change in Durham, N.C.

Dr. Musante was the first person to adapt the principles of behavior modification to the eating habits of significantly overweight people and food abusers alike. Thousands of people have benefited from his methods and guidance at Structure House. Participants learn why they have been making negative food choices and move on to learn about taking personal responsibility for their food choices and habits to maintain a healthier lifestyle. A respected leader in the field, Dr. Musante testified as an expert witness on obesity before the U.S. Senate Committee on the Judiciary in October 2003 in support of the Commonsense Consumption Act. He also serves on the N.C. Health and Wellness Trust Fund Commission's Study Committee for the Prevention and Treatment of Childhood Overweight/Obesity.

Dr. Musante is the author of The Structure House Weight Loss Plan (2007). Additionally, he has been quoted in publications such as The New York Times, the Atlanta Journal-Constitution, Newsweek and People magazine. Dr. Musante has appeared on national television shows, including a feature segment on CNN’s “Anderson Cooper 360,” and with Morley Safer on the acclaimed CBS news program “60 Minutes” as well as "Donahue" and "Good Morning America." He wrote the introduction to James Coco's book, If I Can, You Can.

Dr. Musante's road to success began when he undertook the study of obesity as a psychologist at Duke University Medical Center. There he developed the techniques that not only enabled him to lose the weight, but to keep it off. Dr. Musante received his professional training from New York University, the University of Tennessee, Duke University Medical Center and Temple University Medical School. He is a member of a number of professional organizations, including the American Psychological Association and the Association for the Advancement of Behavior Therapy. He has served on the editorial board of Addictive Behavior, and as a consultant to the National Board of Medical Examiners.  

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