Transcript of conference held at Jul 24, 2025 in room first_test@conference.miaiconvo.com Initial people present at 6:05:50 PM: Brian Lam - Patient Joseph Kirby - Doctor Paul Hershberger Transcript, started at 6:05:50 PM: ________________________________________________________________________________ <6:05:50 PM> Paul Hershberger joined the conference <6:05:50 PM> Joseph Kirby - Doctor joined the conference <6:05:50 PM> Brian Lam - Patient joined the conference <6:05:51 PM> Joseph Kirby - Doctor: you know <6:05:51 PM> Joseph Kirby - Doctor: so Brian <6:06:06 PM> Joseph Kirby - Doctor: now that we're kind of getting the end of this appointment I want to let you know I'm a little concerned about Bob's weight <6:06:07 PM> Brian Lam - Patient: really <6:06:13 PM> Joseph Kirby - Doctor: yeah you know he's in the 95th percentile and it seems like he's really struggling to make friends and such and I'm just curious what your thoughts are about that <6:06:24 PM> Brian Lam - Patient: he's a big kid but I thought you know <6:06:31 PM> Brian Lam - Patient: want to feed him well to so that <6:06:34 PM> Brian Lam - Patient: you know they can be healthy and all that <6:06:37 PM> Joseph Kirby - Doctor: mmm <6:06:37 PM> Brian Lam - Patient: well I know like <6:06:41 PM> Joseph Kirby - Doctor: what do you think the risks are of of him being a high weight <6:06:51 PM> Brian Lam - Patient: for adults being like <6:06:54 PM> Brian Lam - Patient: at a highway <6:06:56 PM> Brian Lam - Patient: you need to like you know diabetes and all that but kind of thought that as a kid you just <6:06:58 PM> Joseph Kirby - Doctor: right <6:07:03 PM> Brian Lam - Patient: how to grow out of it wouldn't say puberty hits you know like they just get taller and <6:07:09 PM> Brian Lam - Patient: all sort itself out <6:07:10 PM> Joseph Kirby - Doctor: right so you know it a serious saying like like most people think that it's not as big of a deal when they're <6:07:11 PM> Brian Lam - Patient: yeah right like they're just gonna grow <6:07:22 PM> Joseph Kirby - Doctor: right and what do you think is led to this <6:07:23 PM> Brian Lam - Patient: well I think <6:07:27 PM> Joseph Kirby - Doctor: mmm <6:07:30 PM> Brian Lam - Patient: you know like he's <6:07:34 PM> Brian Lam - Patient: feeling like certain types of food like try to make <6:07:39 PM> Brian Lam - Patient: other dishes maybe you know like will make a salad or <6:07:44 PM> Brian Lam - Patient: or make some broccoli or cabbage <6:07:44 PM> Brian Lam - Patient: or something <6:07:49 PM> Brian Lam - Patient: healthier and like he doesn't want to eat it and it's like what am I gonna do like stars starving like I feel like <6:07:55 PM> Joseph Kirby - Doctor: yeah and and I hear what you're saying like <6:07:57 PM> Brian Lam - Patient: you just got like I can't starve him so I have to just <6:08:01 PM> Brian Lam - Patient: he wants to eat <6:08:03 PM> Brian Lam - Patient: okay <6:08:06 PM> Joseph Kirby - Doctor: know at the end of the day if he eats eats you know <6:08:09 PM> Joseph Kirby - Doctor: I can't starve them <6:08:11 PM> Brian Lam - Patient: oh <6:08:14 PM> Joseph Kirby - Doctor: but <6:08:16 PM> Joseph Kirby - Doctor: I just wanted to point out to you that there are risks to this weight <6:08:22 PM> Joseph Kirby - Doctor: these for kids <6:08:24 PM> Joseph Kirby - Doctor: um but <6:08:25 PM> Joseph Kirby - Doctor: um with that in mind <6:08:27 PM> Brian Lam - Patient: mm-hmm <6:08:29 PM> Joseph Kirby - Doctor: uh <6:08:32 PM> Joseph Kirby - Doctor: I hear what you're saying that it's very hard to feed him good foods but it seems like you also understand that there are some risks to this weight gain can you kind of explain the discrepancy there between those two things <6:08:42 PM> Brian Lam - Patient: I think <6:08:50 PM> Joseph Kirby - Doctor: mmm <6:08:54 PM> Brian Lam - Patient: you know like <6:08:58 PM> Brian Lam - Patient: yeah being a big kid <6:09:01 PM> Brian Lam - Patient: it's not good I think <6:09:05 PM> Brian Lam - Patient: like it doesn't kind of like to play a lot outside <6:09:10 PM> Brian Lam - Patient: I don't know exactly what's going on but <6:09:15 PM> Brian Lam - Patient: in sometimes feels like he might be picked on <6:09:21 PM> Brian Lam - Patient: kind of because he's <6:09:22 PM> Joseph Kirby - Doctor: yeah here we were saying like he's been picked on a bit <6:09:23 PM> Brian Lam - Patient: because he's a bigger kid <6:09:26 PM> Brian Lam - Patient: yeah <6:09:30 PM> Joseph Kirby - Doctor: um <6:09:30 PM> Joseph Kirby - Doctor: How do you <6:09:32 PM> Brian Lam - Patient: I mean I think <6:09:32 PM> Joseph Kirby - Doctor: think that would get worse if he gained more weight <6:09:41 PM> Brian Lam - Patient: think you know getting pipped teased and picked on my turn into bullying at some point <6:09:48 PM> Brian Lam - Patient: and I think <6:09:50 PM> Brian Lam - Patient: you know like <6:09:52 PM> Brian Lam - Patient: I think it'll just be harder socially <6:09:57 PM> Joseph Kirby - Doctor: right <6:09:57 PM> Brian Lam - Patient: for him if you know like he <6:10:02 PM> Brian Lam - Patient: keeps getting keeps gaining weight <6:10:06 PM> Joseph Kirby - Doctor: and from like a scale to one to ten ten being like the most motivated you can be <6:10:14 PM> Joseph Kirby - Doctor: all motivated you feel to to make a change to help Bob lose some weight <6:10:20 PM> Brian Lam - Patient: I mean <6:10:22 PM> Brian Lam - Patient: I mean I haven't really thought of kind of <6:10:28 PM> Brian Lam - Patient: that so aspect right up run to like now in this visit but knowing that feel like I'm pretty motivated put it like a seven or eight <6:10:40 PM> Brian Lam - Patient: well I think <6:10:41 PM> Joseph Kirby - Doctor: and why not like a five or a six <6:10:44 PM> Joseph Kirby - Doctor: hmm <6:10:46 PM> Brian Lam - Patient: know I think I think <6:10:48 PM> Brian Lam - Patient: my son doesn't <6:10:51 PM> Brian Lam - Patient: like <6:10:56 PM> Brian Lam - Patient: like if you if he doesn't get that social aspect down you might just be like a weird kid right and you know <6:11:04 PM> Brian Lam - Patient: but wouldn't want that to happen to him <6:11:05 PM> Joseph Kirby - Doctor: right I see what you're saying like you don't want this to keeping them long term <6:11:08 PM> Brian Lam - Patient: mm-hmm <6:11:14 PM> Brian Lam - Patient: mm-hmm <6:11:14 PM> Joseph Kirby - Doctor: and <6:11:16 PM> Joseph Kirby - Doctor: said you're about a seven out of 10 7 or an eight but what would it take to get you to like a nine or a 10 out of 10 <6:11:25 PM> Brian Lam - Patient: I think it's hard just the mental like like I said earlier like <6:11:29 PM> Joseph Kirby - Doctor: right <6:11:33 PM> Brian Lam - Patient: if he doesn't want to eat I might just gonna <6:11:37 PM> Brian Lam - Patient: item star for them I think <6:11:39 PM> Joseph Kirby - Doctor: right I'm hearing is that you want to help them but you may be you're not totally certain on how <6:11:40 PM> Brian Lam - Patient: it's hard to get over that as a parent you know like you care for them you love them you want to provide but <6:11:47 PM> Brian Lam - Patient: but <6:11:47 PM> Brian Lam - Patient: and then <6:11:48 PM> Brian Lam - Patient: if you want to lose weight I see that sometimes maybe you <6:11:53 PM> Brian Lam - Patient: you gotta break out of that mentality <6:11:57 PM> Brian Lam - Patient: yeah I would say that <6:12:03 PM> Joseph Kirby - Doctor: um <6:12:07 PM> Brian Lam - Patient: I'd say like <6:12:09 PM> Joseph Kirby - Doctor: and on a scale 1 to 10 how able would you say that you are in general to help him 10 being like you could totally do it and wouldn't be like not at all <6:12:18 PM> Joseph Kirby - Doctor: hmm <6:12:19 PM> Brian Lam - Patient: if you you know put my wife into this I think together we can do it I think I'd say it's like 9 or 10 like we always want the best for our kids so <6:12:35 PM> Joseph Kirby - Doctor: what what kind of changes do you think you can make that would help with this diet problem <6:12:36 PM> Brian Lam - Patient: but I think <6:12:38 PM> Brian Lam - Patient: I think <6:12:40 PM> Brian Lam - Patient: I think we just kind of got a <6:12:44 PM> Brian Lam - Patient: maybe learn <6:12:48 PM> Brian Lam - Patient: sometimes <6:12:51 PM> Brian Lam - Patient: I think <6:12:56 PM> Brian Lam - Patient: you know just <6:12:57 PM> Paul Hershberger: what's up here <6:13:01 PM> Brian Lam - Patient: pretty much putting on our foot down making me you know the greens that he doesn't want to eat <6:13:08 PM> Brian Lam - Patient: um taken away maybe stop drinking soda <6:13:12 PM> Brian Lam - Patient: Sweet Tooth too maybe like moderation is key right ________________________________________________________________________________ End of transcript at Jul 24, 2025, 6:13:28 PM