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Guest column, Norine Ania Germain: When starting a weight loss journey, evaluate the factors that have attributed to weight gain
Norine Ania Germain
Norine Ania Germain, MD

I have known my nanny since the age of 8. Since the time I met her, I knew that she and I would get along wonderfully. 

She became like family to me. She had this peaceful and caring aura that made me feel loved and taken care of. 

My nanny was obese ever since I first met her, but little did I know that her obesity would one day cause her a health crisis.  

Fast-forward to the age of 26, while in lockdown in Connecticut during the pandemic, I received a phone call from my mom telling me how my nanny was not physically and mentally well. 

As the conversation unfolded, my mom said my nanny’s blood sugar has been so high that her organs began to shut down. She was so confused, she could not recognize those around her or even my voice over the phone. 

It was painful not to have a loved one recognize you, mainly due to a preventable cause. Needless to say, my nanny needed a drastic change. 

According to the CDC, obesity increases the chance of someone dying earlier than expected because of obesity-related disease such as high blood pressure, high blood sugar and high cholesterol. These three factors are a big contribution to heart disease, heart attacks and strokes — all of which can lead to death or severe disability. 

Did you know that if you have difficulty sleeping, snoring, fatigue, osteoarthritis or even depression, these things could be related to obesity?  

Obesity-related diabetes can also lead to a host of increased cancer risks such as breast cancer, ovarian cancer, colorectal cancer, pancreatic cancer and liver cancer.

Wow, very eye opening — but there is good news! People do win their battle with obesity. The first step when starting a weight loss journey is to evaluate the factors that have attributed to weight gain. Let’s explore them now:


My family and I often tried to educate my nanny on the importance of losing weight, eating better and exercising. However, back home in Haiti, the norm was to be on the heavier side because it signifies being healthier. For some cultures, such as the Haitian culture, being bigger is a sign that you are eating the proper food, that you are stronger, or even protected from injuries and sicknesses. 

I have also noticed in my culture, how some women would put on unhealthy weight and compromise their health because of the attraction some men have for heavier-looking females simply because of their curves. 

Although I applaud people who embrace their natural size, small or big, I worry when size interferes with the quality of life. 

My nanny was consuming high levels of saturated fat, sugar and carbohydrates without worrying about the consequences on health because culturally, that is all she was comfortable with. 

In the case of my nanny, her eating habits were not the best, but obesity often has multiple causes. Genetics plays a big role in determining the size of our bodies. However, it is not the only factor contributing to our weight — let’s talk about our environment. 


When we talk about environment and obesity, it means several things: 

  1. Quality of the food available
  2. Accessibility to various foods
  3. Culturally based foods
  4. Socioeconomic status 

Back home in Haiti, many of our meals are prepared with oils, carbohydrates and sugar. Our culture has a direct impact on our health, and we are what we eat. 

I understand that culture plays a big part in our identity, but consuming these comfort foods in moderation is far better for our health. We should incorporate more vegetables, fruits and leaner proteins — such as lean cuts of meat, fish and chicken breast (no skin). 

Healthier oils include almond oil, avocado and olive oil. Studies have shown that incorporating these types of food may help us live longer, lower the risk of heart diseases or diabetes, help maintain a healthy weight and improve quality of life overall. 

For those who can afford these products, I highly recommend that route, but some cannot afford it. One resource that could help is the Georgia Mountain Food Bank. This organization provides more nutritious food options that they distribute in specific neighborhoods through certain organizations, and they even provide recipes. You can get more information on their website, 


When people hear exercise, it can be an overwhelming concept; however, exercise combined with a better diet increases health benefits and can be achieved in small daily steps. We know it’s essential to stay active throughout the day, and lucky for us, exercise can be achieved in various forms. 

If you enjoy going to the gym, great! Others enjoy walks, bicycle rides, dancing or playing sports. For people with limited time, I suggest going up and down the stairs at work, walking in the hallways and even parking the car farther away from your destination to maximize walking. Small, consistent daily effort will compound over time.  

When diet and exercise just don’t work

For those who cannot exercise due to medical conditions, old age or simply do not see results with dieting and exercising on their own, I strongly recommend visiting your primary care physician. We can discuss and create exercise plans, refer you to a nutritionist for a better diet, possibly provide weight loss medications and certainly provide you with important moral support. 

If further help is needed, bariatric physicians who are specialists in weight loss, can help determine what other weight loss options are available. These specialized physicians are available in our Gainesville community. Check out to learn more.

My nanny improved her health

My nanny improved significantly after being hospitalized and by making drastic changes to her diet. She now exercises four to five days per week, at least 30 minutes at a time. She loves to jump rope — an excellent form of exercise — and has lost 30-40 pounds! 

It is crucial to fight obesity for all these reasons, as doing so will significantly increase your quality of life. Take care of the body you are in, as it is the vessel that constantly helps us go through every day! 

Dr. Norine Ania Germain is a part of the family medicine resident program at Northeast Georgia Health System. Columns publish monthly from residents in the program.