Dieting is important, but we must make sure our emotional and spiritual condition is healthy if we want to shed extra pounds.
Two significant enemies of the physical and psychological health of millions of Americans today are obesity and depression. In fact, obesity and depression go hand in hand. An estimated 25 percent to 30 percent of obese patients who seek weight-reduction treatment suffer with depression or other psychological disturbances.

Because both obesity and depression are common conditions, it's often difficult to determine if one is related to the other or if the person afflicted with both conditions simply has two common problems, occurring simultaneously, but totally unrelated to each other. Statisticians refer to this as "association vs. causation."

When an obese person is also depressed, it helps to know if the obesity is merely associated with the depression or if there is a cause-and-effect relationship. If the answer is one of causation, the depression must be addressed as part of the overall approach to weight loss.

Why is it that it's nearly impossible to succeed in losing weight in the face of untreated depression? Because eating behavior and the attitude toward exercise are both influenced by depression.

Depression leads to overeating when food is used to soothe its symptoms. And depression destroys motivation, which is so necessary to prompt regular exercise. To make matters worse, depression can be triggered by repeated failures with weight-loss plans, an experience common to most people who have attempted to lose weight.

So the dieter subjects himself to cycles of hope and despair, which are powerful triggers for depression. The initial hope that this will be the diet, this will be the program, this will be the plan that finally works is ultimately destroyed by failing to reach the goal.

When failure is internalized, the result is a damaged sense of self-worth: "I not only am overweight; I also am an overweight failure."

Causes and Cures of Obesity

Though it is clear that depression can be triggered by events such as the death of a loved one, divorce or the cycle of hope and despair so often experienced by the dieter, the actual cause of depression remains unknown. However, we do know that several factors are linked to the development of depression:

Depression tends to run in families and is more common in women, which suggests a genetic predisposition.

Social factors play a role. People who have secure and stable relationships are less likely to become depressed than those who do not.

The significance of healthy relationships in protecting against depression is confirmed by international data, which show a low incidence of depression in cultures where there are strong community and family ties.

There is evidence that an imbalance in the levels of neurotransmitters contributes to the development of depression.

Grief following the death of a spouse often leads to depression.

Major illness increases the likelihood of depression. The depressive disorders are two to three times more common in nursing-home residents, hospitalized patients and patients with chronic medical problems.

Drugs have been developed as one form of treatment for depression. One category of antidepressant drugs is called "serotonin-reuptake inhibitors." These alter the brain's concentration of the neurotransmitter serotonin.

Some of the drugs in this particular class were found to have an interesting side effect: They suppress the appetite. This gives credence to the theory that mood and eating behavior are linked.

If we accept this theory, then it's easy to conclude that the best way to treat both depression and obesity is with medications. Though medications may work well, they are not the only forms of therapy to consider. For example, behavioral therapy and psychotherapy--for groups or individuals--are also quite effective and do not require the use of drugs.

I personally believe that, for the Christian, the best form of therapy is a personal choice--to experience joy.

A Prescription for Healing

True joy can lift us out of the depths of depression and give us the power that we need to succeed in losing weight.

What does joy look like? In the Bible, particularly in the Old Testament, joy denotes a feeling of exuberance and gladness.

Joy was outwardly expressed through singing, shouting and dancing. For example, King David leaped and danced with joy when he returned the ark of the covenant to Jerusalem (see 2 Sam. 6:14).

As a fruit of the Spirit, joy resides in the Christian; it is present at all times, regardless of negative circumstances. I have concluded, after much observation, that depression cannot prevail in the person who has a firm understanding of godly joy.

Joy and depression, like light and darkness, are contrary to each other. As such, they cannot coexist. This is not to say that there are no depressed Christians--there are.

But as believers, when we recognize depression is working in us we can make use of the most effective form of therapy. Choosing to experience God's divine joy should be step one in the treatment plan.

It is important to understand that experiencing joy and feeling happy are not synonymous. Happiness is dependent upon circumstances. Joy, however, relates to agape love; it is unconditional.

If the Spirit of God dwells in us (as He does all Christians), joy is present, even in times of sorrow and despair. Experience teaches us that grief and disappointment are a part of life--they touch the lives of Christians and non-Christians alike.

When faced with adversity, and when the pain from trials and circumstances is severe, according to the Bible, we can still "take heart."

Keys to Joy

In Scripture, Jesus desired for His disciples to have His joy. This is clear from His statement: "These things I have spoken to you, that My joy may remain in you, and that your joy may be full" (John 15:11, NKJV).

Our desire is that we experience "complete joy." To do this we need to grasp the significance of Jesus' words.

Key 1: Experience God. Jesus was sharing with His disciples the nature of the believer's relationship with God the Father and with Himself, God the Son, in the analogy of the vine and the branches found in John 15:1, 5, 9-11. The verses reveal to us the first key to having godly joy: that we believe in Christ.

Jesus spoke these words the night before His death, giving the promise of His joy to His disciples. He was speaking to all of His disciples except for Judas, the betrayer, who had left the group earlier that evening to arrange for Jesus' arrest. So the disciples who remained were believers; they had faith in Christ.

To receive the promise of "complete joy," we must enter into a faith-based relationship with Jesus, accepting Him as our Savior.

Without this relationship--without first becoming branches of the vine--we can never know what it means to experience His "complete joy."

Key 2: Exalt God. The second key to experiencing complete joy is found in Psalm 100. This psalm opens with the appeal to "shout for joy to the Lord, all the earth." This is joy made manifest, an exuberance that is outwardly expressed.

For some, it may seem difficult to give themselves to such candid expression. Yet God has power enough to free us from our inhibitions. One solution for our reticence is found in verse 3 of Psalm 100: "Know that the Lord is God."

As we realize who God is, our response will be to exalt Him in praise and worship. The depth and magnitude of our joy depend on how fully we understand the wonder of who God is and His love toward us.

Key 3: Hope in God. The psalmist cried out: "Why are you downcast, O my soul? Why so disturbed within me?" (Ps. 42:5, NIV).

His response to that question offers another key to experiencing joy: "Put your hope in God, for I will yet praise him, my Savior and my God" (v. 5). Our hope that is yet unfulfilled rests in our knowledge that we as believers will spend eternity with our Lord.

When we experience adversity on earth, hope reminds us that trouble is nothing more than a temporal challenge. It pales in importance as we anticipate an eternity spent with God.

He has provided His love and joy in every challenge of life we face. As we focus on this spiritual reality, hope will begin to fill our hearts and minds, and release the joy of the Lord to work in our lives.


Kara Davis, M.D. is a doctor of internal medicine and an assistant professor of clinical medicine at the University of Chicago. She is the author of The Spiritual Secrets to Weight Loss (Charisma House), from which this article was adapted.
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