Transcript of conference held at Aug 25, 2025 in room first_test@conference.miaiconvo.com Initial people present at 5:59:31 PM: Bethany - doctor Anthony - patient Angie Castle Transcript, started at 5:59:31 PM: ________________________________________________________________________________ <5:59:31 PM> Anthony - patient joined the conference <5:59:31 PM> Bethany - doctor joined the conference <5:59:31 PM> Angie Castle joined the conference <5:59:32 PM> Bethany - doctor: okay Anthony so overall Jimmy's well child check seems to be you know all healthy I know we talked about his diet a little bit how do you feel about his weight <5:59:47 PM> Anthony - patient: um <5:59:49 PM> Bethany - doctor: mm-hmm <5:59:51 PM> Anthony - patient: I don't think much about it he seems healthy he's a five-year-old healthy little boy <5:59:57 PM> Anthony - patient: purchase <6:00:00 PM> Bethany - doctor: so um based on his growth chart and is like wait for length ratio he's pretty high up there so he's definitely on the larger size for kids his age what do you think about that <6:00:14 PM> Bethany - doctor: okay um but as far as his diet goes <6:00:16 PM> Anthony - patient: it's always been a bigger boy <6:00:19 PM> Anthony - patient: I think I'm a bigger guy and I don't think <6:00:19 PM> Anthony - patient: I think <6:00:23 PM> Anthony - patient: the way he's built <6:00:26 PM> Anthony - patient: yeah he's a picky eater but <6:00:29 PM> Bethany - doctor: been a picky eater <6:00:31 PM> Bethany - doctor: mm-hmm and what are you getting him to eat <6:00:35 PM> Anthony - patient: bring him food and he <6:00:38 PM> Anthony - patient: we get them to eat what we can get them to eat <6:00:42 PM> Anthony - patient: um like you said he is picky so just whatever we're having at home my wife and I usually make something side on for him some like mac and cheese or some chicken nuggets <6:00:44 PM> Bethany - doctor: here <6:00:50 PM> Bethany - doctor: okay and why is that when did that start <6:00:58 PM> Anthony - patient: um I want to say that started anytime recent <6:01:01 PM> Bethany - doctor: okay <6:01:07 PM> Anthony - patient: ever since he's been little he's just <6:01:10 PM> Bethany - doctor: have you ever tried to <6:01:11 PM> Anthony - patient: eater <6:01:12 PM> Anthony - patient: oh yeah um but then he just sort of throws a tantrum and he'll go without eating we've tried like <6:01:14 PM> Bethany - doctor: fur like what you're eating or fruits and vegetables <6:01:18 PM> Bethany - doctor: okay and does that what do you how do you feel about that <6:01:25 PM> Anthony - patient: not cooking himself but then he goes all day without eating <6:01:33 PM> Anthony - patient: that's frustrating but <6:01:37 PM> Bethany - doctor: okay and what do you know about diet and how that you know affects growth and development in children <6:01:37 PM> Anthony - patient: eat something <6:01:37 PM> Anthony - patient: eventually comes around in <6:01:40 PM> Anthony - patient: and we have heel grab a snack later on the day and he'll be fine <6:01:45 PM> Anthony - patient: here <6:01:52 PM> Anthony - patient: oh I think you are what you eat on <6:01:57 PM> Anthony - patient: and as long as you're eating getting enough calories and and you'll be good he's a grown boy so he needs to eat <6:02:03 PM> Bethany - doctor: yeah <6:02:05 PM> Anthony - patient: I know that <6:02:06 PM> Bethany - doctor: okay so so far <6:02:10 PM> Bethany - doctor: I talked about it you were making him his own meals but not necessarily getting a well-balanced diet <6:02:16 PM> Anthony - patient: it's a struggle <6:02:17 PM> Bethany - doctor: okay what do you think will happen if he continues to eat this way <6:02:19 PM> Anthony - patient: um well he hasn't hit its gross spurt yet I know he's a little round but I think once as he gauges you'll grow and fit into his body more <6:02:22 PM> Bethany - doctor: okay what if that doesn't happen what if you know he continues to grow height wise but remains like at a heavier weight <6:02:44 PM> Bethany - doctor: Mmm Yeah <6:02:45 PM> Anthony - patient: I'm not sure I know his friends make fun of them when they're outside playing I don't want that to happen anymore like I'm hoping that goes away but <6:02:56 PM> Anthony - patient: five year old kids and <6:02:59 PM> Anthony - patient: it's what they do <6:03:00 PM> Bethany - doctor: um does that prevent them from being able to go outside and play <6:03:02 PM> Anthony - patient: it does there's been a number of instances where he was outside running around with his friends and he came in and all upset and we asked him what was going on and <6:03:02 PM> Anthony - patient: there <6:03:06 PM> Bethany - doctor: and how do you think you know not getting out there getting exercises affecting his weight <6:03:16 PM> Anthony - patient: in front of his way and they were calling him fat or whatever <6:03:20 PM> Anthony - patient: all right I don't think it helps I know that <6:03:30 PM> Anthony - patient: but there's also I feel bad for the kid that he's out there getting made fun of and just breaks my heart <6:03:39 PM> Anthony - patient: so I understand <6:03:40 PM> Bethany - doctor: was there any family history of like type 2 diabetes <6:03:42 PM> Anthony - patient: yeah um I have type 2 diabetes my father has it so I know that's an issue and I've been through <6:03:46 PM> Bethany - doctor: yeah <6:03:56 PM> Anthony - patient: management for that <6:03:58 PM> Bethany - doctor: yeah well the Jimmy is getting rather close to meeting you know qualifications for childhood obesity and with that comes an increased risk of type 2 diabetes even in his age what are your thoughts about that <6:04:03 PM> Anthony - patient: oh <6:04:14 PM> Anthony - patient: I didn't know that can happen so young <6:04:16 PM> Bethany - doctor: yeah um so I would say like with everything with the diet you know not getting like the nutrients he may need for growth to development and not getting as much exercise because his friends are making fun of him like I'm a little bit concerned given that he's already overweight kind of reaching that obesity category and putting him at risk for you know type 2 diabetes <6:04:18 PM> Anthony - patient: Indonesia <6:04:28 PM> Anthony - patient: um means mothers have talked about it <6:04:48 PM> Bethany - doctor: so have you ever thought about maybe you know trying to work with this with him <6:04:59 PM> Anthony - patient: but anytime we try to make a change or get him to eat what we're eating he just throws a tantrum and it's difficult so I don't know <6:05:10 PM> Bethany - doctor: and it's hard as this age and you know five year old doesn't understand why you know he has to eat the vegetables and stuff of you know getting candy but <6:05:13 PM> Anthony - patient: yeah I mean if you think it's that big of a problem I'm sure we could <6:05:22 PM> Bethany - doctor: what would like a single you know kind of baby step look like that you know we could try the forest next appointment to see about you know at least sneaking in some more you know nutritious food <6:05:36 PM> Bethany - doctor: yeah and like nowadays there's a lot of you know recipes online for you know adding veggies to something he might eat already and kind of like pureeing them so he doesn't realize <6:05:43 PM> Anthony - patient: maybe start getting him to eat some veggies <6:05:47 PM> Anthony - patient: along with whatever extra we're cooking in <6:05:59 PM> Anthony - patient: um <6:05:59 PM> Anthony - patient: I'm not <6:06:04 PM> Bethany - doctor: they're in there um what's something else that you can think about maybe kind of help that's either diet or exercise wise <6:06:12 PM> Bethany - doctor: okay um <6:06:15 PM> Anthony - patient: sure like <6:06:17 PM> Anthony - patient: I can feel like we've tried a lot it's frustrating when he's throwing Tantrums but I'm not sure what else besides getting him to maybe eat a few more vegetables <6:06:29 PM> Bethany - doctor: well if you're looking for additional guidance on something like this we could refer you to a dietitian who would have more insight into ways to like prepare foods and making sure he's getting like nutrients he's needed and addition to like what he does eat what are your thoughts about that <6:06:46 PM> Anthony - patient: I don't I don't think we're that bad um yeah like you said he's round and I don't want to <6:06:50 PM> Bethany - doctor: okay <6:06:57 PM> Anthony - patient: give him diabetes or anything but I don't think we're at the point of <6:07:01 PM> Anthony - patient: we have you doc <6:07:05 PM> Bethany - doctor: um you know that is true however you know diet isn't my expertise so if this is something that can continue we would want to refer you to a dietitian in the meantime like let's make a game plan for you know what is the one thing you want to include and then we'll follow up in a couple months and see how that's going do a weight check and kind of go from there <6:07:31 PM> Anthony - patient: okay ________________________________________________________________________________ End of transcript at Aug 25, 2025, 6:07:36 PM