Recent research suggests that obesity rates among clergy are higher than in the general population. This is a curious finding in light of the call to virtue and moderation that most priests and ministers espouse. In this article I would like to explore some of the possible explanations for this and examine some practical ways members of the clergy can address this all-too-visible problem.
Obesity has been a public health concern in the U.S. for decades now: it is widely acknowledged that a third of the population is clinically obese, which is defined as a Body Mass Index (BMI) of 30 or greater. This means that a six-foot-tall man who weighs 225 pounds would be regarded as obese. Another third is considered overweight (BMI=25-30). If the same six-foot-tall man weighs between 185-224 pounds, he would be considered overweight. Now the BMI is a statistical estimate of adipose tissue (fat), and it does not uniformly apply to everyone: many athletic men with greater muscle mass may actually have a high BMI but would not be considered overweight or obese. But in general it is a useful tool.
The health consequences of excess weight are numerous: heart disease, stroke, diabetes and a variety of degenerative diseases, including osteoarthritis. Nor are the statistics regarding weight loss encouraging at first glance. Three-fourths of people who lose weight gain it back within the first year; two-thirds gain more. These numbers give even the most fervent dieter pause.
But let’s look beyond the first glance and consider: these rates compare favorably to many kinds of accomplishment. About 27 percent of students who enroll in college graduate in four years. Fewer than 10 percent of the population have advanced degrees. Only .1 percent of the population has run a marathon. So 20 percent success rate for something that requires dedication, persistence and going against the generally accepted norms of our society is a respectable number. It demonstrates that, though difficult, weight loss can be done successfully.
The causes of obesity are numerous and frankly speculative. We live in a society where food is abundant and relatively inexpensive. Much of our food consumption includes processed foods which contain numerous caloric additives. Complicating those factors is the generally sedentary lifestyle that most Americans enjoy. And finally, elevated levels of stress, with the accompanying release of cortisol, work against weight reduction.
For members of the clergy there are additional factors at play in weight management. A recent study pointed to mobility, inadequate social support, and high time demands, including intrusions on personal boundaries. These combined stressors decrease engagement with healthy behaviors.
Other factors also play a role. Self-care is not always valued among members of the clergy, who are prone to overworking. Specific skills for managing stress are neglected or are completely off the radar screen. Finally, many conscious or unconscious beliefs about how ministry should be conducted or lived impact self-care. The invitation in ministry to focus on others, for example, unfortunately often occurs at the expense of the priest, who desires and believes he should be a mentor, guide and inspiration to others. He may idealize the biblical notion of pouring himself out for the sake of the community, as Jesus did. These and similar beliefs often leave little room for proactive self-care.
Becoming a Problem
Many people struggle with a few extra pounds, but when does weight gain actually become a significant problem? There are two broad measures of this. The first involves the impact excess weight has on health: when a man begins to have heart problems or diabetes or osteoarthritis attributable to increased weight, it is a clear signal that weight gain has become problematic.
The second index is more subtle but no less pernicious. This occurs when a person’s eating habits become compulsive in nature. At this point, one’s relationship with food begins to resemble the relationship between an alcoholic and beverage alcohol. That is, there is a loss of control over one’s eating habits, a preoccupation with food intake, and a discernible pattern of compulsive overeating supported by compulsive defenses These include rationalization, denial and emotional avoidance.
Denial is a powerful defense mechanism. It enables a person to watch his weight go up, buy bigger clothes, and see other people getting proportionately smaller while not paying attention to these obvious facts. How destructive is denial? Very. If we ignore obvious facts, we lose the ability to direct and control our own behavior. Throw in increased busyness and workaholism, and you begin to get a picture of what compulsive overeaters look like among the clergy. In addition, blindness to one major aspect of life tends to foster blindness in others as well This negatively impacts one’s judgment.
Nor is denial the only problem. Compulsive behavior is often typified by submerging personal affects or feelings. Anger and resentment begin to accumulate as the skills to deal with these feelings diminishes; one’s spiritual life begins to falter; the focus of one’s life becomes increasingly external as opposed to internal. When these dynamics set in, considerable effort is required to rectify them successfully.
At the core of compulsive behavior is anxiety, and priests struggle with a unique set of triggers to this condition. Priests live in a fishbowl: everyone watches what they do, know what their weaknesses are, and remember what they say. They perform liturgies for hundreds of people routinely. They stand between God and man with all the tensions such a position engenders. These are heavy and often anxiety-laden responsibilities.
Addressing the Problem
Most people are polite; they do not like to call attention to the faults or vulnerabilities of others. Especially around something so sensitive as someone’s weight. Especially when that person is a priest. So those who know a priest who is losing control of his weight often collude with his compulsion by silence. Or the priest himself may make humorous references to his girth. This kind of denial is collaborative; there are others who are in on the cover-up.
So what is to be done? Somewhere, somehow something needs to be said in a caring and compassionate manner. It is curious that most priests who are overweight and come in for assessment seldom arrive at our doorstep because of their weight. They come because they are depressed or anxious or because they have gotten into some kind of trouble or because someone is complaining. But men are rarely referred because their health is being threatened by increased weight.
Human problems seldom come in neat and tidy boxes. It is safe to say that if a person is depressed and overweight, addressing one without addressing the other is less likely to be successful. The most effective treatments are the most comprehensive.
So what do you do when someone has come to the realization that his weight is excessive? There are two scenarios: one in which a man comes to this determination himself and does not struggle with an addictive process; the other when compulsion is in full swing.
First, the Realization
Many authors have described the stages of changing in one’s behavior in slightly varied forms. I prefer the following: precontemplation, contemplation, decision or commitment, planning, implementation, and maintenance.
Precontemplation is a stage where one is thinking about thinking about changing one’s behavior. It may not be entirely conscious but may be manifest in the tendency to begin to notice things: for instance, that you are the biggest person in the room; that your clothes sizes are getting seriously large.
Contemplation, the next stage, occurs when a person starts to recognize that weight gain is indeed a problem and begins to ask himself specific questions: What can I do about this? How can I do it? This is generally a sobering time, as a person turns his attention to what he is now understanding to be a serious problem.
The next stage is the most critical. That is when the time for decision and commitment occurs. This is not solely an intellectual exercise. It typically involves the emergence of strong feelings of conviction, passion, desire and an openness or at least a willingness to change. It is at once a recognition of the problem and a commitment to health; it is a choice. And it is a choice without which nothing changes.
Yet this decision, this commitment is not simply to weight reduction. Almost anyone can lose a few pounds. What is required is a commitment to changing one’s relationship with food and eating. Abundant evidence suggests that short-term weight loss programs, while they can be successful, most often do not lead to permanent weight loss.
The next stage is planning. There are a variety of tools to utilize in this stage. Weight Watchers, Web-based plans, prepackaged food plans: the specific program makes little difference relative to the decision and the strength of commitment. It is true, however, that, whatever the program selected, it must have certain elements: keeping track of one’s caloric intake via a food log; eating breakfast every day; eating real as opposed to processed food whenever possible, and maintaining a regular exercise program are all essential features of a successful weight management plan. Another rule: no exceptions! At least not for the initial period of weight reduction.
The next stage is implementation, where the selected plan is put into practice. This is the part where habits actually begin to change and one’s relationship with food undergoes a transformation. Nothing happens unless the plans are executed in as strict a way as possible. There is no doubt that this is the stage that tests one’s commitment the most. It is easier to think about eating differently than actually doing so.
The final stage is maintenance. Based on the reduction strategy, a plan for eating on an ongoing basis will need to be carefully delineated. This is not the chore many people expect it to be. In fact, this is the part where one actually lives the dream, where one’s pride in his appearance improves and where he has access to greater health and vitality. In addition, you have the satisfaction of knowing that you accomplished something difficult. You’ve beaten the odds.
The second scenario is more complicated, the one that involves compulsion or addiction. In this one, it is possible to go through the stages above, but many, perhaps most, people need help with addictive behavior.
Addiction is a complicated problem. Often addicted people sense that their behavior is out of control, but denial keeps that realization at bay. They often feel remorse or regret when they overeat or hide or hoard food. They often find themselves angry and resentful, and anger is often accompanied by a what-the-heck attitude. Rationalizations are numerous and always available: I’m hungry; I’m tired of the discipline of caloric restriction; food is to be enjoyed; I deserve this pleasure; I’m too busy to do anything about it. These and similar notions have the virtue of being true or nearly true. They also have the unfortunate consequence of sabotaging good intentions and sound plans.
For these reasons, some external structure, some system of accountability is often needed. This can range from a support group, such as Overeaters Anonymous (OA) to a structured treatment program. Often both are required. Treatment allows for a clear plan and a stable system of accountability. It provides a way of facing reality and neutralizing the ready rationalizations with which the mind of the compulsive is so fraught. And if done in a structured program, it provides a community of people who are engaged in recovery, a culture that provides significant support. Respect, candor and accountability are the hallmarks of a sound treatment program.
So what are the tasks of treatment? First, stopping the addictive behavior. That means that a person has to have a clearly defined eating plan and must stick with it. Second, detailing the progression of the addictive behavior is essential: how and when did food become the focus of addiction? Third, identifying the triggers the lead to overeating: these could include stress or loneliness or boredom or criticism or any one of a number of common human experiences.
Then the hard part. Compulsive behavior often covers over deep anger and hostility, and bringing this into the light of day is a major goal of treatment. Normalizing anger, examining the underlying belief structure, and acquiring improved skills for managing it are the tasks of treatment.
Interpersonal relationships are also critical. Often the addicted person’s primary — and sometimes only — relationship is with the object of the addiction. In this case, food and eating. A person must learn to replace that seductive but futile relationship with relationships with real people. Even priests need the support, challenge and feedback that close relationships provide. Celibacy does not mean isolation; in fact, it means freeing oneself up to be available for protected relationships. And it requires meaningful relationships to sustain it in a healthy way.
So what do we know? We know that excess weight is a serious physical and psychological problem. We know that dealing with it requires honesty, courage and dedication. We know that it is possible to change one’s behavior and one’s life, even if most people in the population do not do so. And we know that people who struggle with weight issues deserve compassion and respect in addressing such a pervasive issue in their life.
We also know that the benefits of success are numerous, especially for members of the clergy: better health, a longer life, increased personal pride and greater and more sensitive care and compassion for others. These are well worth the struggle. TP
Dr. Midden, Ph.D., is a psychologist and the founder and clinical director of the St. Louis Consultation Center (www.stlconsult.org), a treatment program specifically designed for priests and religious men and women.