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weight loss; diet
client
Well, I think it's because I've been eating more fruits and vegetables, that- that's it.
n/a
sustain
2
weight loss; diet
therapist
And how many servings of fruits and vegetables on average per day would you have?
question
n/a
2
weight loss; diet
client
To be honest, I have four or five -- four to six glasses of orange juice a day. Um, I have fruit for lunch and breakfast. I have, uh, usually one to two servings of a vegetable like lettuce or broccoli with thinner.
n/a
neutral
2
weight loss; diet
therapist
John, it's very important that you recognize that some fruits, but especially fruit juice can contain a huge amount of calories. Did you know that a glass of orange juice has almost as many calories as a can of cola?
therapist_input
n/a
2
weight loss; diet
client
No, I didn't know. Um, but doesn't the fruit- food pyramid classify, um, fruit juice as a- a serving?
n/a
neutral
2
weight loss; diet
therapist
You're absolutely right, but keep in mind that the food pyramid is to be used as a guideline only. When it comes to nutrition, we have to have a more personalized approach. So I have a hunch, and that is the excess fruit that you were consuming probably caused your weight rebound. What's your impression?
therapist_input
n/a
2
weight loss; diet
client
Well, this changes quite a bit. I mean, here I'm thinking that my fruit intake is making me healthier and actually it's making me fatter.
n/a
change
2
weight loss; diet
therapist
Indeed. Let me ask you something, knowing what you know now, how important is it to you to lose the weight by decreasing the amount of juice that you're currently taking in?
question
n/a
2
weight loss; diet
client
Obviously, I need to cut back on the fruit juice. But boy, do I love that OJ.
n/a
change
2
weight loss; diet
therapist
Oh, I understand. Let me ask you this, on a scale from 0 to 10, 0 meaning that there's no way you can do it, and 10 meaning that you're 100% confident that you can do it, how confident are you that you'll be able to reduce the amount of juice you're currently taking in.
therapist_input
n/a
2
weight loss; diet
client
Um, six or seven.
n/a
change
2
weight loss; diet
therapist
All right. So, you're not a zero. So, that tells me that you've got some confidence that this is doable, this is something you certainly can do it. Why are you not a zero?
question
n/a
2
weight loss; diet
client
I guess it's because I know that I need to do it to lose the weight.
n/a
change
2
weight loss; diet
therapist
So, you realize, again, that if you decrease the amount of juice you're taking in, you're gonna decrease your weight, you're gonna feel better, and you're gonna impact your po- health positively?
reflection
n/a
2
weight loss; diet
client
Yes.
n/a
change
2
weight loss; diet
therapist
But you're also not a 10, and that tells me that there may be some obstacles to your success. What would it take for you to be a 10 or even an 8 or 9?
question
n/a
2
weight loss; diet
client
Getting the fruit juice of the house because I know if it's there I'll drink it. My wife does the shopping for us, so maybe if I ask her not to get the juice, that would solve it.
n/a
change
2
weight loss; diet
therapist
Okay. Now, if the juice was still there, can you think of anything else you could do?
question
n/a
2
weight loss; diet
client
I suppose I could replace it with, um, a low-calorie drink or drink more water.
n/a
change
2
weight loss; diet
therapist
Excellent. John, I get the impression that you want to stay in course with weight reduction. And the best way to do this will be to decrease the amount of juice that you're currently taking in. So if I saw you in two weeks and I asked you how much juice you're t- drinking and how you did it, what would you tell me?
reflection
n/a
2
weight loss; diet
client
I'd say I didn't have any and I substituted it with, um, sugar-free drinks.
n/a
change
2
weight loss; diet
therapist
Excellent. Well, it sounds like you have a plan. Same scale, 0 to 10, how confident are you that you can, uh, make this happen?
question
n/a
2
weight loss; diet
client
A 10.
n/a
change
2
weight loss; diet
therapist
I agree. All right. Well, you-you know what? I'm not gonna start any medications today. Your levels were a little bit off, but I think we can handle this from a purely lifestyle standpoint. What do you think?
therapist_input
n/a
2
weight loss; diet
client
Great. It sounds good to me.
n/a
change
2
weight loss; diet
therapist
Excellent. I'll see you in two weeks.
therapist_input
n/a
2
weight loss; diet
client
Okay.
n/a
neutral
3
problem recognition
client
Well see, my-my wife's been getting on me a lot lately about trying to improve my health habits, and I really don't see what the big problem is. I mean, I've been working real hard. Sometimes I can't come home for dinner, so I'm having to go out to eat at Applebee's or something like that, so-- but she seems to have a bigger problem, I really don't see what the big deal is.
n/a
neutral
3
problem recognition
therapist
Okay, and so what I'm hearing is that you don't feel like your health is concerning you right now, or anything like that?
reflection
n/a
3
problem recognition
client
I-I-I feel fine.
n/a
neutral
3
problem recognition
therapist
Okay.
other
n/a
3
problem recognition
client
I mean, my-my work is really man-manual labor-intensive so I'm usually working out in-in the hot sun the majority of the day, so I'm usually sweating out any like bad things I put in my system, so—
n/a
neutral
3
problem recognition
therapist
Okay. Have you noticed putting on any weight, or anything like--?
question
n/a
3
problem recognition
client
Well, a little bit, but nothing too-- you know. I'm not blo- I'm not bloated or anything.
n/a
neutral
3
problem recognition
therapist
Okay. Okay. And how about going to see the doctor? Have you gone to-- for a visit or anything recently?
question
n/a
3
problem recognition
client
Well, yeah, I've been to the doctor about maybe last year for a physical, but-- I mean, everything showed up to be fine, so—
n/a
neutral
3
problem recognition
therapist
Okay. But you feel that you feel good?
question
n/a
3
problem recognition
client
Yeah.
n/a
neutral
3
problem recognition
therapist
Okay. Um, and so what I hear is that you're-- you feel like your wife might be, uh, overreacting to this?
reflection
n/a
3
problem recognition
client
Well, I mean, not really overreacting. I know that she loves me and I know she-she wants me, uh, you know, live a long time and be healthy, but just sometimes, especially if you work a hard job, like kinda going out to eat at these places kinda makes you feel a little bit better about your situation.
n/a
neutral
3
problem recognition
therapist
Sure. Sure. Okay. Um, and so one thing I'd just like to do is maybe give you some information on, um, maybe obesity or diabetes if you're interested or open to that. If you're, you know--?
question
n/a
3
problem recognition
client
Sure. [unintelligible 00:01:33]
n/a
neutral
3
problem recognition
therapist
Okay. Good.
other
n/a
4
better oral health
therapist
Hi, Emily.
other
n/a
4
better oral health
client
Hi.
n/a
neutral
4
better oral health
therapist
It's been a while.
other
n/a
4
better oral health
client
Yeah, it's been a while.
n/a
neutral
4
better oral health
therapist
This is something new.
reflection
n/a
4
better oral health
client
Oh, oh, yeah, the—Yeah
n/a
neutral
4
better oral health
therapist
You got your lip pierced. How long ago did you get that done?
question
n/a
4
better oral health
client
About a month.
n/a
neutral
4
better oral health
therapist
Hmm.
other
n/a
4
better oral health
client
Yeah.
n/a
neutral
4
better oral health
therapist
What made you decide to get-get a lip piercing?
question
n/a
4
better oral health
client
Um, I don't know. I just felt like something different. I was getting bored and, I don't know, it's kind of nice to stand out a bit, I guess.
n/a
neutral
4
better oral health
therapist
Hmm.
other
n/a
4
better oral health
client
Yeah, change.
n/a
neutral
4
better oral health
therapist
Yeah, and it looks nice.
other
n/a
4
better oral health
client
Thanks.
n/a
neutral
4
better oral health
therapist
Um, I guess, you know, as your dentist, I have- I have a couple of concerns about lip piercings, oral piercings. I wonder what have you heard about how having an oral piercing can affect your-your teeth or your gums?
question
n/a
4
better oral health
client
I don't actually, really. I-I mean, I'm sure that it might push on my gums or teeth, but I don't know how much it will impact that much. I've pretty good teeth. I don't know.
n/a
neutral
4
better oral health
therapist
Mm-hmm.
other
n/a
4
better oral health
client
I don't really know [unintelligible 00:01:04]
n/a
neutral
4
better oral health
therapist
You do. you have beautiful teeth as I always tell you-
other
n/a
4
better oral health
client
[laughs] Thanks.
n/a
neutral
4
better oral health
therapist
-every time you come in.
other
n/a
4
better oral health
client
Yeah.
n/a
neutral
4
better oral health
therapist
Um, I mean I have had some patients with oral piercings and they can erode some of the gum right, um, just right there at the front.
therapist_input
n/a
4
better oral health
client
Mm-hmm.
n/a
neutral
4
better oral health
therapist
Um, so that's one-one thing, and the other is, um, I do see fair amount of chipped teeth-
therapist_input
n/a
4
better oral health
client
Oh, yeah.
n/a
neutral
4
better oral health
therapist
-just from contact with it. I wonder what are your thoughts about that?
question
n/a
4
better oral health
client
Well, I definitely don't want it mess with my teeth. I know I kinda already have low gums to begin with, like you've been telling me for a while, and I have to flo-floss, which I-
n/a
change
4
better oral health
therapist
Yes, flossing.
reflection
n/a
4
better oral health
client
Um, which I'm not doing but, um, yeah, I guess, I don't really wanna wreck my teeth 'cause-- Yeah, I didn't really notice any of the chipping.
n/a
change
4
better oral health
therapist
There's nothing yet.
reflection
n/a
4
better oral health
client
I guess I'm not paying attention to it.
n/a
neutral
4
better oral health
therapist
Yeah. There's certainly been-- There's no problems and you, as you said, only have had it for a short time.
reflection
n/a
4
better oral health
client
Mm-hmm.
n/a
neutral
4
better oral health
therapist
Um, what would- what would make you decide, "This is something that's not right for me?"
question
n/a
4
better oral health
client
I don't know, I guess if I started to see that it was actually causing a problem, then I might.
n/a
change
4
better oral health
therapist
Mm-hmm.
other
n/a
4
better oral health
client
But for now-- I mean, I just got and-
n/a
neutral
4
better oral health
therapist
Mm-hmm.
other
n/a
4
better oral health
client
-and it looks pretty cool.
n/a
sustain
4
better oral health
therapist
I guess that it does.
other
n/a
4
better oral health
client
Yeah, I kinda-- Yeah.
n/a
neutral
4
better oral health
therapist
Yeah, it looks nice. So, you want to monitor it and-and-
therapist_input
n/a
4
better oral health
client
Yeah.
n/a
neutral
4
better oral health
therapist
-really watch-
therapist_input
n/a
4
better oral health
client
Yeah.
n/a
neutral
4
better oral health
therapist
-the effect? Okay.
therapist_input
n/a
4
better oral health
client
Yeah. I guess if I really start to see a problem-- I mean, this might not last forever, but my teeth, I'm hoping-
n/a
change
4
better oral health
therapist
Mm-hmm.
other
n/a
4
better oral health
client
-will kind of stick [unintelligible 00:02:30]
n/a
neutral
4
better oral health
therapist
Emily, you said it so well it-
other
n/a
4
better oral health
client
Yeah.
n/a
neutral
4
better oral health
therapist
-the-the piercing might not last forever, but your teeth really are-
reflection
n/a
4
better oral health
client
Yeah.
n/a
neutral
4
better oral health
therapist
-hopefully forever. So, okay, well thanks for-for talking about it-
other
n/a