Breege Geoghegan is a 24-year-old pastry chef from Portmanock near Dublin. Her erratic unhealthy eating habits and her lack of exercise are potentially robbing years from her life. She needs to completely overhaul her bad habits now before it's too late.
Something had caused her to slowly gain weight. Dr Mark needed to get to the bottom of what was wrong with her lifestyle if he was to have any hope of improving her life expectancy.
He wanted Breege to understand why the body starts gaining weight and that exercise and a sensible eating plan was the key to loosing it.
By carrying excess weight Breege is putting herself at greater risk of diabetes, some cancers, hypertension, angina, heart attacks and osteoarthritis. She also could be reducing her life expectancy by around ten years.
Changing your lifestyle is difficult but Breege recently became engaged and Dr Mark hopes that her future wedding will provide motivation for her to take her health and life expectancy seriously.
Breege will undergo a complete medical. Her blood tests will indicate a lot about any potential health risk. The fat content of her blood will be measured and a fasting blood sugar level will reveal if she is already suffering from diabetes. Dr Mark is also interested to find out if the blood and other tests reveal whether there is anything medical which is causing Breege to put on weight.
Her heart rate is also measured to make sure there is no evidence of heart disease. It's found that Breege's heart is healthy but she will need to tackle her weight if she's going to keep it that way.
The doctor measures Breege's height and weight in order to calculate her body mass index, BMI. BMI is calculated by dividing your weight in kg by your height in metres squared. A healthy BMI is below 25. Anything over 30 is classified as obese and Breege's is 36. Obesity is not just about how you look - 90 percent of people with type 2 diabetes are obese or overweight. She needs to reduce her weight now before it's too late.
Because of her weight her lungs are performing 10 years worse than they should, but if she reduces her weight she will be able to reverse this. Dr Mark is concerned, though, about how badly this is affecting Breege's short-term health so he sends her for a fitness and skin fold test.
Over 6 sites Breege averaged 311mm of body fat, which is too high. In 8 weeks she will be tested again. But for now it was time for Breege's first proper bit of exercise for 5 years.
By measuring her breath and blood lactate levels during exercise Dr Mark will be able to calculate Breege's relative vo2 max, which will tell him how fit Breege is. Ideally her score should be above 50. However, Breege's relative vo2 is only 22.5 which means she is very unfit. If she doesn't want to lose years from her life she has to improve on this.
Back at the hospital all the results of the medical are in. The good news is Breege is not yet diabetic; the bad news is there are other areas of concern. Her triglyceride level is 2.65; a healthy level is below 2.18.
The medical had confirmed what Dr Mark suspected - her weight was going to take years of her life and the only thing causing it was an unhealthy lifestyle. It was time to have a serious chat about her results.
Breege Goeghegan is a 24-year-old pastry chef whose poor eating habits and lack of activity are taking years of her life. A full medical screening has highlighted fats in the blood and an obese body mass index. It has also confirmed that the only cause of Breege's high weight is an unhealthy lifestyle. In 8 weeks she will be retested.
In order to increase Breege's life expectancy Dr Mark's plan over the next 8 weeks is to slowly increase Breege's activity levels to at least 30 minutes a day, 5 days a week, and to give Breege a low fat healthy eating plan.
Today is day one of Breege's new lifestyle and Dr Mark wants her to build activity into a daily routine. Breege only lives about 5 kilometres from work. If he can convince her to cycle or walk to work she will get all the exercise she needs just from her daily commute. But it's been five years since Breege last did any exercise; this change of lifestyle is not going to be easy.
Research suggests that each hour of exercise can lengthen life by roughly two hours, but six out of ten people in Ireland do not take enough activity to see any health benefits.
Dr Mark is worried that Breege will find changing what she eats incredibly difficult - especially as she makes rich high fat deserts for a living. He hopes that a farmers' market and advice from nutritionist Dr Kathy Fulcher will get Breege excited about healthy food. If Dr Fulcher can convince Breege to sort out her diet then she can really begin adding years onto her life.
Dr Fulcher has given Breege a weekly eating plan which includes low fat proteins like fish and chicken, low fat energy foods like brown rice, and plenty of fresh fruits and vegetables. Breege has also been advised to eat 3 regular meals a day. That means no more skipping breakfast and no more late-night takeaways after work.
4 weeks in and despite her good intentions Breege is finding the eating plan difficult. She's also worried that her weight isn't falling off as quickly as she'd like. Weight loss is never constant or easy, Dr Mark is worried that if Breege gets too obsessed with short-term setbacks then the whole plan could become derailed.
Studies have shown that a low self-esteem can affect general health. Dr Mark hopes that Image Consultant Anne-Marie Boland can help. By showing Breege how to look good she should raise her confidence.
It will be a long time before Breege gets to her ideal weight but feeling good about herself now will give her motivation.
Dr Mark tells Breege that it's vital that she concentrate on the long term. To inspire her he shows her computer-generated photographs of what she might look like at a healthy weight. He hopes she realises that if she wants to live longer her new life style has to go beyond the 8-week challenge.
The healthy eating plan may be difficult to adjust to, but by week 7 exercise has become part of Breege's life.
8 weeks ago Breege Geoghegan set out to add years to her life expectancy, and reverse years of damage caused by bad eating habits and lack of exercise. Has she managed to make any difference to how long she lives?
Weight Loss 6 kg
BMI 34 - previously 36
Waist 43 inches - previously 47 inches
Triglycerides 1.74 - previously 2.65
Body Fat 21% reduction
Relative VO2 37.1 (30 % improvement)
Life expectancy - 10 added years.
Breege is definitely heading in the right direction. She is no longer tired all the time, she has more energy and feels a lot healthier. She has made time for exercise and changed her bad eating habits. In doing so she has potentially added a decade of quality years to her life.