The Berman Method
The Berman Method
Episode #202: When a Giant Waffle and 2 Sprites Cross the Line
The healthcare system's double standards regarding weight management take center stage as Dr. Jake and Jenni Berman share their frustrations about being scrutinized for having children in the lower weight percentiles while witnessing extreme childhood obesity go unaddressed.
During a recent breakfast outing, they observed a six-year-old boy at least 50 pounds overweight consuming a nutritional disaster—Sprite and syrup-drenched waffles totaling 1,300 calories and 235 grams of carbohydrates in a single meal. This sparked a passionate discussion about what they term "the curse of the provider"—how healthcare professionals often assume patients understand basic health fundamentals when many lack this essential knowledge.
The Bermans don't mince words, calling this nutritional neglect a form of child abuse. They highlight the absurdity of a medical system that threatens to classify their active, healthy daughter as "malnourished" based solely on percentile charts, while seemingly turning a blind eye to obesity that guarantees future health problems. This disconnect reveals deeper issues within our healthcare approach, where providers may avoid direct conversations about weight for fear of causing offense.
Beyond weight management, the podcast explores practical solutions like continuous glucose monitors (CGMs) that help bridge the gap between thinking you're eating healthy and knowing you are through objective data. The Bermans emphasize that our nutritional needs change over time, making regular reassessment crucial even for health-conscious individuals.
Thought-provoking and occasionally provocative, this episode challenges listeners to question conventional wisdom, advocate for themselves within the healthcare system, and recognize that sometimes being "an asshole"—persistent in asking questions—is necessary when navigating a system that often prioritizes profits over patient outcomes. Ready to take control of your health knowledge? Start by understanding the fundamentals that even doctors sometimes forget to explain.
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This is the Berman Method podcast featuring Dr. Jake Berman and physician assistant Jenny Berman. We are here to treat problems and not symptoms. Disclaimer: this podcast is for entertainment purposes only and not to treat anyone or to give medical advice. If you are interested in any information that we are giving and would like to use this for yourself, we recommend that you contact your primary care physician or reach out to us and ask us questions about yourself specifically. Enjoy.
SPEAKER_00:Rolling baby, rolling, rolling, rolling with a baby sleeping in the car seat right next to Jenny's feet as she shushes me.
unknown:Shh.
SPEAKER_00:I'm shushing your alerts on your computer. Turn those notifications off. Come on, focus. I need 100% of your attention right now.
SPEAKER_01:I am focused. You have a hundred percent of my attention, but don't wake up my baby.
SPEAKER_00:Don't wake up the sleeping baby. Speaking of babies, holy cow, we have to talk about the baby that we saw at first watch.
SPEAKER_01:He was not a baby.
SPEAKER_00:But before we get into all that, we are David going against Goliath. Goliath being the corporate medical system, big pharmaceutical companies, the health insurance companies, they do not have your best interests in mind. They will choose profits over patient outcomes, time and time again. You have to be your own self-advocate. You've got to ask questions. You've got to become an asshole. Ask, ask, ask, ask, ask, like Vera does. I want a cookie, Dad. No, I want a cookie. No, I want a cookie. No. Can I please have a cookie? I'm gonna die if I don't have a cookie. Okay, here's have the cookie.
SPEAKER_01:Have five cookies.
SPEAKER_00:Have ten. That's not the way that our house works. I'm just saying.
SPEAKER_01:Uh yeah. Right. Great example. Not with cookies, anyway. Can we go on the swing? No. Can we go on the swing in five minutes? Can we go on the swing? Okay, fine. Yeah, it's let's go on the swing.
SPEAKER_00:It's definitely the swing, not cookies. Too funny. She is addicted to the swing.
SPEAKER_01:She loves the swing and the trampoline.
SPEAKER_00:The swing and the trampoline and the monkey bars.
SPEAKER_01:If she could just spend all day outside on the swing, she would be totally happy.
unknown:Yeah.
SPEAKER_00:Yeah. So here we are. Another episode. We're 200 episodes into this thing. I think this is 202 or something, something like that. I can't believe you guys are still listening to us. This is amazing.
SPEAKER_01:And giving us some feedback.
SPEAKER_00:Yes. A lot of feedback. Some questions. Great questions. Great questions. One of the things that we struggle with as providers is being cursed. It's called the curse of the provider, meaning that a lot of times we think that the very essentials, the basic fundamentals, are understood by all. And sometimes we overlook the basic fundamentals because we think that you know that, and we should communicate some higher, more complicated, higher level, more complicated things. And it's just not true. So often it's not true. I mean, something as subtle as posture, pull your belly button in and lift your chest up and do it at the same time. Don't do it individually. And that will help you wake up the right muscles at the right time to help you with your posture. Versus, so many people think that improving your posture is done by pulling your shoulder blades down. And that's not true at all.
SPEAKER_01:Right. You don't even think about the chest. I was just talking to this with a patient yesterday who had a breast reduction, and we were talking about her feeling symptoms in her shoulder and down her right arm, and how they're sending her for more testing for thoracic outlet syndrome. And I'm like, well, why haven't we first looked at the posture? Like, why are we jumping to needing testing with a neurologist when we haven't established posture post-breast reduction? Like you don't know what muscles to use.
SPEAKER_00:You're hitting the nail on the head, and I can't tell you how many times I've had that conversation with ladies that I've worked with over my career where when your breasts are bigger than normal, that's more weight pulling you down all the time. And one of the most common things that's either said explicitly or thought sub uh subconsciously is you feel self-conscious about that. Right. So you drop them down, you don't stick them out like Dolly Parton. And when you drop your chest down to hide your breasts, that's where it all goes south.
SPEAKER_01:Right, right. And then it's be it's like this second nature, right? Like it's just what you do, you don't even realize that your posture is not good. So then you do get a breast reduction, and even though you don't have as much weight on the front, your muscles are still not good. Your muscles are still not activating, your muscles are still not working, even though the weight is gone. We haven't trained them to do the right things. And I use myself as an example. When I am nursing the babies after having them, I gain, I don't know, six sizes on my breasts.
SPEAKER_00:Massive.
SPEAKER_01:I mean, absolutely. I go from very small to huge, and not that I need to give you guys way too much information about me.
SPEAKER_00:Let's keep going with this.
SPEAKER_01:But how many times did you have to correct me when my chest got so big because I just didn't have the right activation? It wasn't that I wasn't strong enough, I just didn't have the right posture, the right activation to keep my sternum up.
SPEAKER_00:Yeah. Yeah, those were great days. Oh my gosh. Really good days. I mean, awfully there were points where I thought I was cheating. I'm like, who are you?
SPEAKER_01:Can you stop?
SPEAKER_00:Are you blushing right now? Why are we not doing a video podcast? Why are we not doing a video podcast right now?
SPEAKER_01:Okay, so moving on to really what we wanted to talk about today. It's the curse of the provider.
SPEAKER_00:The curse of the provider and just basic, basic, basic fundamentals. I'm sure that we're preaching to the choir here, but it's so important. I mean, you guys gotta understand these basic fundamentals. And one of the things that we experienced this past weekend was we were visiting friends on the East Coast, and Sunday morning we went to breakfast at First Watch, which is one of our go-to places. So we found one over there and went to it, and it was borderline child abuse. And I don't know how we are not calling this child abuse. And I guess the only reason why we're not calling it child abuse is because I don't know how to even explain it without getting too political. But it was just it was in effing sane what this mother was allowing this boy, this young boy. How old was he? Maybe six. Maybe six. How much overweight was he?
SPEAKER_01:At least 50 pounds overweight.
SPEAKER_00:Minimum 50 pounds. I mean, I'm looking at this poor kid and I'm going, you've got no chance. You are the laughing stock of the classroom. There's no way that you're playing on the playground. It's not physically possible. He's a freaking cannonball. And there's no way to explain this without being vulgar and mean. But the reality is, it I'm not gonna sugarcoat it because he'd eat that too. Like this was it's not nice, but god damn it, like this is crazy.
SPEAKER_01:Right. Here we are having to have weight checks on our child because she's underweight according to seriously, according to the computer system. She's underweight. So we're having to bring her back every month for weight checks, even though I'm very knowledgeable in how I'm feeding her and the macros I'm providing to her. But yeah, this boy is well overweight.
SPEAKER_00:I mean, not well overweight, severely overweight. And here we are getting grilled by our pediatrician threatening us to classify her as malnourished, which puts us in this whole other category. And I'm going, are you effing kidding me?
SPEAKER_01:Right, right.
SPEAKER_00:Why are we getting threatened by a pediatrician for malnourishment?
SPEAKER_01:And not maliciously threatening, just she's like, you know, I gotta do my job. It's it's you know, out of the sense that she has to do her job, and that's what has to be put in as the ICD 10 diagnosis code because uh according to the charts on the computer, she's underweight, whatever. Back to the boy.
SPEAKER_00:We're sitting here. Luckily, my back was to him, and Jenny was facing him because she's calling it out like a look at Walker. He woke up. All smiles, all smiling. What's up, Walker? What's up, Mama? So here we are. Jenny's calling this out to me play by play, and she's going, He's drinking Sprite for breakfast.
SPEAKER_01:Hold on. The conversation started with this boy behind you is sitting right next to his mom at the table, watching his phone or her phone, whoever's phone, with headphones on in a restaurant, and that's what he's doing. And she's on her phone, and they're sitting side by side, just the two of them at the table, both on their phones with his headphones on. And that was my first comment. I was like, wow, that's an interesting dynamic, as they're sitting side by side in a booth doing this by themselves, nobody else. Yeah, and then yes, I commented that and he's drinking Sprite for breakfast, which this was 8:30 in the morning. We were there relatively early, yeah. So earlier than we typically on a Sunday would go to breakfast with the kids. So I was like, Sprite for breakfast, and then then breakfast came out. I watched his plate come out, and it is a waffle. And while his mom was pouring a quarter cup of syrup on the waffle, he was eating one slice of bacon, and then he proceeded to eat the whole waffle with all the syrup on, and then had another sprite.
SPEAKER_00:A refill on the sprite.
SPEAKER_01:A refill of the sprite.
SPEAKER_00:And we're talking about a six-year-old boy that's 50 pounds overweight, and it's just I'm sitting there going, the only way that this is possible is that it's sheer ignorance, meaning that she just has zero knowledge that this is poison. Because if she had any knowledge at all, this is child abuse.
SPEAKER_01:Right, right. I mean, it's freaking child abuse. Probably sitting here thinking she's doing something good because at least he's not getting caffeine in the sprite. But what she doesn't know is he's getting 74 grams of sugar and carbohydrates through those two sprites that he had.
SPEAKER_00:I mean, it's just insanity that we allow this. Now, to be fair, I had the worst breakfast on the menu, but I did it knowingly. I got the chicky changa and what is it, 1400 calories probably for that breakfast.
SPEAKER_01:I'll I'll look at uh currently first though I have the macros of the breakfast that the boy ate.
SPEAKER_00:So let's talk about that real quick. Here's the macros.
SPEAKER_01:Then I'll go back to your chicky chunga. So he had about 1300 calories through that breakfast, just that breakfast, which is probably a daily intake of a six-year-old child, normally calorie-wise. He had 24 grams of protein, and that's between having the fruit. He did have one sausage link and one slice of bacon, and then of course the the waffle. That's one and a no, probably yeah, one and a half of what you eat on a daily basis.
SPEAKER_00:Oh, so that's 50% more carbs than what I consume in an entire day.
SPEAKER_01:Yeah.
SPEAKER_00:Me at 190 pounds. Grown man who exercises, shredded, rip nasty, 11% body fat.
SPEAKER_01:Is that the right number?
SPEAKER_00:It is the right number, damn it. Maybe not after last weekend.
SPEAKER_01:So yeah, and then 37 grams of fat and six grams of fiber, which fiber's not a macronutrient, but out of 235 grams of carbs, he only had six grams of fiber.
SPEAKER_00:So that's just it's insanity. And I know that this is this is probably coming across wrong and judgy. And it is. We're judging the crap out of this because this is wrong. This is child abuse. You would never buy a dog and keep it in a cage for its entire life because you'd call that animal abuse. So why? Why are why is this not red flagged? Why is this, why is this okay? Now, what I was saying is, yes, I got one of the worst breakfasts that same morning on the menu. It's a chicky chonga. It's 1400 calories minimum, and it's just full of carbs, but it's also got a lot of protein. It does. But the difference is I'm knowingly doing it, and it's a fraction of my diet. Right. I'm knowingly, I went into there intentionally, new knowing that I was gonna get the worst thing on the menu.
SPEAKER_01:Right.
SPEAKER_00:And it's not healthy at all.
SPEAKER_01:Right.
SPEAKER_00:Right.
SPEAKER_01:But it's not even a weekly thing for you. It's not daily, it's not weekly, you're educated behind it. And this this is the problem. The education is not out there for the lay person.
SPEAKER_00:It it isn't. The person, the average public doesn't understand what they're doing. You're essentially guaranteeing diabetes is gonna happen.
SPEAKER_01:Right.
SPEAKER_00:Like non-negotiable, six years old, 50 pounds overweight, pounding, it's cups and cups of sugar straight to the face, first thing, 8 a.m. in the morning. You're set up for failure for the rest of the day. Like this is just crazy. Absolutely crazy.
SPEAKER_01:And why are we not able to provide more education to the lay person? You know, to these parents on, and I'm not making any assumptions, but if they don't have the right insurance or they're on Medicaid, or even if they do have good insurance, why are we not providing the ability for them to have more knowledge and education behind these foods?
SPEAKER_00:I agree with you.
SPEAKER_01:Neither are medical doctors. They're not getting the education.
SPEAKER_00:I agree. Now, let's be fair. There's nothing cheap about first watch. You first watch is not Denny's, it's not Waffle House. Sure. First watch, you're paying a fair a good amount of money to go to breakfast there. Right. So we're not gonna sit here and say that this mother's son was financially unable to afford making that acquisition.
SPEAKER_01:But I mean, just in general, I said even with good insurance, we don't provide them the ability to learn these things.
SPEAKER_00:Yes. So we've just got to understand. Now, here's the important part. I had a CGM on, a continuous glucose monitor. I had one on, and I intentionally on the last episode, I told you that I was gonna put one on. And I knew the weekend that I had ahead of me, and I knew what my intentions were Sunday morning, eating a eating one of my most favorite breakfasts, and I wanted to see exactly what my blood sugar did. Unfortunately.
SPEAKER_01:And he's not making it up.
SPEAKER_00:Unfortunately, the CGM quit working. It malfunctioned the day before. And this that these things happen from time to time. It's tech, right? Technology doesn't always work all the time, and it quit working the night before, maybe because I stressed it too much. I don't know. But the point of this is that so many people think that you're doing the right thing. There's a difference between thinking that you're doing the right thing and knowing that you're doing the right thing because your body changes. Meaning that how often you've been doing this for how many years now? How often do food sensitivity test results change?
SPEAKER_01:Every couple of years. I mean, we generally will check every three years. We give it time, yeah. But it changes. It does for sure.
SPEAKER_00:So what you thought was healthy and proper for your body, your diet, your lifestyle five years ago doesn't necessarily mean that's true today.
SPEAKER_01:Oh, absolutely, especially with hormones changing as we age or stressors occurring. Absolutely.
SPEAKER_00:Yeah. So that's the number one reason why I wanted to put a CG um CGM on again was because I wanted to know am I still eating enough protein? Am I still consuming enough fiber through cooked veggies? Or am I not? Because I think I am. Right. I think so. But I want to know there's a difference between thinking and knowing and seeing it in real time. And before this CGM malfunction, I was going, oh wow, this is actually starting off better than the last time that I wore one.
SPEAKER_01:Right, right.
SPEAKER_00:I'm like, okay, so we did something right. Still wasn't great, but it was definitely better than the last time that I started off with.
SPEAKER_01:So every human should have to wear one.
SPEAKER_00:You should. The reality is every human should have to wear one because what you think is happening and what is actually happening is so rarely ever consistent.
SPEAKER_01:Right. Absolutely.
SPEAKER_00:I mean, it's the age-old thing. That's the reason why we're 200 plus episodes into the Berman Method podcast because it never ends.
SPEAKER_01:When I think wearing one, like even for this little boy, maybe it would give some education to his mom if the alarm on the CGM is going off every hour after he eats whatever, then maybe that would provide some education that, hey, this isn't the right thing, and I should probably find help on what is the right thing.
SPEAKER_00:Wow. Absolutely amazing. I mean, gosh, I hope that we ruffled some feathers on this episode. I just can't, I can't hold back anymore. I just can't do it. This is just insanity, absolute insanity. It's child abuse. And the reason I guess the reason why I'm so passionate about it now is because we're getting grilled with our own kids. And you know us, you know Jenny. She posts pictures of every single meal she eats. It's not like she's maliciously posting pictures of healthy meals, and then once the camera and Instagram goes away, we're feeding them cakes and cookies and Burger King and McDonald's and bullcrap.
SPEAKER_01:Right.
SPEAKER_00:Like they don't even know what McDonald's is. Right, right. Never had McDonald's in their life.
SPEAKER_01:They haven't. And you know, to that point, is they do eat healthy, but I also know what fuel their body needs to be able to grow and develop. So even though we eat lower carb options at dinner time, we eat carbs at lunch, we eat carbs at breakfast, but dinner we generally don't. The girls always have an option for a carbohydrate. They do, right? So they have a carb option at every meal, breakfast, lunch, and dinner, but it's a healthy source of carb. They're not even eating French fries and fried chicken at every meal. They're eating rice and they're eating sweet potatoes and they're eating sometimes they have mac and cheese. But, you know, so they do get these options. And so, yes, that kind of comes back to like we are well educated and we're getting grilled versus a non-educated individual providing their kids the wrong thing.
SPEAKER_00:Yeah, let's dance around the subject. I mean, when's the last time somebody that was severely over obese went to the doctor and the doctor said, You are severely obese. You're fat. Oh, don't say that. You might offend somebody. Okay, well, maybe that's a good thing.
SPEAKER_01:Right.
SPEAKER_00:Maybe offending somebody is a good thing because maybe they actually maybe that was the thing that gets them over the the edge to do something about it and not die.
SPEAKER_01:Right.
SPEAKER_00:Not be hooked on insulin for the rest of their life for type 2 diabetes, which is completely preventable and reversible.
SPEAKER_01:Right. And it's not a shame by you know, shaming by any means, but you know, you do wonder do the obese people come back for weight checks?
SPEAKER_00:That's a good one. We should ask our pediatrician next time. So when you get somebody that's overweight, are you making them come back on a regular basis for weight checks?
SPEAKER_01:Hey. And not to say she's not doing the right thing. Like certainly we need to rule out that there's no growth factor related to this, right? That it's coming from the brain or from a genetic deficiency, that she has a growth hormone issue or a thyroid issue. So I, you know, certainly appreciate the monitoring. However, the coaching probably could be better for fit for a different family.
SPEAKER_00:Oh my gosh.
SPEAKER_01:It does make me wonder like, do the obese have to come back for weed checks?
SPEAKER_00:Yeah. Are they explicitly telling them that you're obese? Or do they kind of like dance around it and say, oh, it's a little bit heavier than we'd like it to be?
SPEAKER_01:I don't know.
SPEAKER_00:Like, I don't want to offend this person, so I'm gonna say, oh, it's a little bit higher than we'd like it to be. It's a little you're a little bit heavier than we'd like you to be. What the hell? Come on, call it like it is, it either is or it isn't. Anybody that's seen our kids look at them and they go, Wow, they're in shape.
SPEAKER_01:Right.
SPEAKER_00:Like they're not malnourished, they're not walking around skin and bones, they're in shape. All they you cannot stop Vera from playing, she is non-stop, just constantly playing. Stella does the same thing. Walker's on his way to doing it, and all three of them are in the one percentile of this modern aged American thing that has been adjusted since the 1980s when they went on record saying that sugar's healthy and it should be a part of the balanced diet. Like, what the hell? Oh, little fun fact do your own research on this one. Now I'm all jacked up.
SPEAKER_01:I was just about to say, okay, good. Turn it off. Get off of your soap.
SPEAKER_00:As soon as you guys end this podcast, I want everybody to look up where the CDC is headquartered in Atlanta. And who owns that building? Who gifted the CDC their building back in the 1980s? Whoever responds back with the correct answer is getting a big prize. So text call, email, let me know who has the correct answer, and whoever's first is getting a good prize. I don't know what it is, but I'm so jacked up right now because I'm so pissed off. But man, look it up. Who gifted the CDC their first building in Atlanta in the 80s? Good?
SPEAKER_01:Okay, ciao. Bye. Thank you for subscribing on your social media and podcast platforms to the Berman Method, Dr. Jake Berman with Berman Physical Therapy, and Jenny Berman, physician assistant with Berman Health and Wellness. You can find more information on our website, www.bermanpt.com for physical therapy, bermanpt.com forward slash wellness for the health and wellness. You can also find us on social media, Facebook, Instagram, and on your podcast platform. So be sure to follow us, like us, subscribe to us. And if you would like any further information, definitely visit our website and reach out to us. You may also find our free reports on the websites as well, where you can download this free information for yourself. Have a great day.