By Anne Blythe
United Methodist clergy have been put through their paces in recent years, with the COVID-19 pandemic and a highly publicized schism over LGBTQ+ inclusion that led to 7,600 churches leaving the denominational fold.
It’s no surprise that those stressors and others have compromised pastors’ physical, emotional and spiritual well-being. That shows up in long-running, regular surveys by Duke researchers.
Every two years since 2008, the Duke Clergy Health Collaborative (previously called the Duke Clergy Health Initiative) has conducted a statewide survey of the well-being of the denomination’s clergy. Over the past decade and a half, results show, members of the profession have been plagued by obesity-related ailments, poor sleep, burnout and mental health challenges.
This year’s report, though, carries a bit of good news.
Overall obesity rates dropped slightly, with some members reporting more significant weight loss. For the first time in 17 years, all three components of burnout — emotional exhaustion, detachment and low personal accomplishment — dropped markedly. And other mental health markers like elevated depression and anxiety remained stable.
Duke researchers attribute some of the mental and emotional health improvement to the dust settling after 25 percent of the churches departed by 2024 when the denomination agreed to lift bans on the ordination of gay clergy and performance of same-sex weddings.
“The disaffiliation had a major impact on the denomination,” David Eagle, research director of the Clergy Health Collaborative and associate research professor of global health and sociology at Duke, told NC Health News. “Most congregations and clergy left by the end of 2023 and then the denomination voted to change its polity in 2024, removing the language about clergy not being able to perform same-sex marriage and whether or not clergy — gay clergy — could be in sexual relationships with people of the same gender.”
Deep Rift
Eagle estimated that about 17 percent of the clergy left with their churches. Others stayed behind with the United Methodist denomination.
“It was almost uniformly conservative clergy and congregations that left,” Eagle said. “So the United Methodist Church has stayed a very centrist denomination with just a slightly smaller conservative tail and a larger sort of liberal end. But that middle part of the church where they’re politically quite mixed — the congregations are politically quite mixed — has really stayed the same, although clergy now tend to be more liberal than they used to be.”
That’s definitely contributing to lower burnout rates, Eagle added, “because during disaffiliation, the congregation had to hold a vote whether they wanted to stay in the denomination, and these were really stressful and there was lots of worry about the future of the denomination.”
The researchers have not been able to keep surveying the clergy who left, even though they’ve tried.
“We did a pilot study where we tried to interview some of those people, and they just didn’t have much interest in talking to us,” Eagle said. “The group of people who left are very suspicious of research. They’re suspicious of the United Methodist Church.”
The Rev. Lindsay Collins, now lead pastor at Union Grove United Methodist Church in Orange County, lost her previous church in Elizabethtown to an unexpected disaffiliation vote in the fall of 2022.
“It was very, very quick,” she told NC Health News.
Collins had moved to that Bladen County church from Roxboro in July 2021, she said, “and the irony was that the only request in my move was that I be sent to a church that was not considering disaffiliation. My brother is openly gay, so there was the added stress of going through this with having the family connection, and I had just said, ‘I can deal with a lot of things, I think that would be too taxing on my mental health.’”
The conference sent her to a church, she said, that they genuinely thought would not take a vote, but there were some underlying factors that church leaders hadn’t known about. In less than three months, Collins was without a church, a home and school for her two children.
“The thing that was really, really hard for me was the time period between early October and the end of December,” Collins said. “The Methodist church had agreed that after the vote, their pastors would serve until the end of the calendar year.”
The people who did not want to disaffiliate had already left the church, and she was left with a congregation looking toward their future and a different pastor.
“It was really miserable,” Collins said. “My family no longer attended church after that because they were uncomfortable.”
Typically new appointments to Methodist churches are made in July, but the change left her searching for pastoral work in January. With little available, Collins considered teaching and even secular jobs.
“You talk about mental health — me and my children and my spouse all had to go for counseling because of the repercussions of having so many moves, unprovoked, in such a short amount of time,” she said. Military people, who move from base to base during their service, helped her through that tough patch. But even with the counseling, she took a smaller appointment than she had served previously.
“I did it for my mental health,” Collins said.
Checking the pulse
The Duke Endowment, a private philanthropic organization founded by James Buchanan Duke, funds the study. The foundation partners closely with the North Carolina Conference and the Western Conference of the United Methodist Church. (NC Health News has been a beneficiary of Duke Endowment grants.)
“We know the people who left, and certainly from a health perspective they were more likely to be men and more likely to be overweight and more likely to be rural,” Eagle said. “So a little bit of the improvement in physical health is also due to the fact that some of the least healthy clergy left during the disaffiliation.”
The researchers reached out to about 1,500 North Carolina Methodist clergy members in 2025 for the report released in October. The biennial reports are intended to help the denomination develop interventions and exercises to better the pastors’ health.
The researchers attribute the drop in obesity among some individuals, in large part, to GLP-1 weight loss medications. Almost 25 percent of the surveyed clergy have tried the popular drugs. Those on the medications between 2023 and 2025 reported losing an average of 16.3 pounds, while those who did not report using them gained an average of 0.9 pounds.
Obesity can contribute to or exacerbate high blood pressure, diabetes, cardiac and joint problems. With church potlucks and parishioners often bringing baked goods and other homemade treats as a thank you, pastors in many denominations are around food a lot.
“We don’t know all of the reasons behind why clergy obesity rates are so high, but it is definitely some combination of an occupation that is quite stressful and uncertain,” Eagle said.
Pastors also face many uncertainties over the normal course of the job. They often work through the day and night, and have to be very intentional to set aside time for themselves they can use to recharge emotionally and physically.
United Methodist pastors have to confront an additional stressor — they are reappointed annually by the denomination. “So every year, there’s this anxiety about ‘will I be moved’ or not,” Eagle said.
Setting aside a Sabbath
The Rev. Tom Greener, lead pastor at St. James United Methodist Church in Greenville, has served in seven churches over his 29 years in North Carolina. All the moves can be taxing on mental health, he said.
“It’s certainly a piece of it, and being unsure of how a congregation does or doesn’t receive you, whether they think you should or shouldn’t stay. It’s hard to hear anybody say ‘We think it’s time for a change of pastors’ and not take it personally,” Greener told NC Health News.
Greener, whose photo is on the cover of the clergy health report, has developed several coping skills and tools to maintain his emotional and spiritual well-being. He has good sleep habits, sets aside time for regular prayer and exercise, and goes on long bike rides when he has the time. Every other Friday morning at 6 o’clock, he and a small group of colleagues and friends join a conference call to check in on each other and talk about what’s on their minds.
“And, in the interest of full disclosure, I take anti-depressants,” Greener said.
It’s not lost on Greener and other ministers that they are often with people during some of the most important — and difficult — moments of their lives.
“For me, that’s a great, great honor,” Greener said. “The thing that I find more stressful is knowing there are people that I am tasked to care for that don’t like me.”
“In any social interaction, you don’t click with everybody,” he said. “But my job is to still be there for them. I try to be as honest as I possibly can with those folks that the relationship is tense. I don’t try to pretend that it isn’t.
“I try to be honest with them.”
The Rev. Casey Mursten, a new pastor at Leasburg United Methodist Church in rural Caswell County, is a Duke Divinity School alumna who, like Greener, makes regular exercise part of her routine, at least two to three times a week.
“When we become Methodist pastors, and we take the ordination vows, we’re held to the highest Christian ideals and standards,” Mursten told NC Health News. “I think that means a lot of things, but I think that certainly includes mental health, physical health, spiritual health — how we are taking care of ourself so we can be the best possible ministers — shepherds — to people.”
To ease stress, Mursten sets aside Friday as her personal Sabbath so she can “rest and enjoy time with God.”
“I think the biggest thing for me is having colleagues who are friends, colleagues who I trust,” she added. “I do have a covenant group that meets regularly, and just having people around where I know I’m not alone in this. This job is unique and special and hard and holy and beautiful. We hold a lot. We hold people’s sufferings and sorrows and confidentiality.
“So to have friends, just to have people that I share openly, I know I am not alone in this,” Mursten continued. “I just think it can’t be overemphasized the importance for me of that truth.”
KEEP UP WITH THE LATEST
Republish our articles for free, online or in print, under a Creative Commons license.
