"When the doctor said I was going to have a heart attack, get diabetes and die, it scared the living daylights out of me," says Kiwi Ashleigh Butcher.
The 20-year-old sitting in that doctor's office weighed 167kg. She was also looking down the barrel of having knee surgery before her 21st birthday after an earlier netball injury was aggravated by her extra weight.
"His words gave me one very big shock and I sat down and had to think about what I was doing to myself at that point in time," says Ms Butcher.
Now 26, the early childhood teacher has undergone a dramatic transformation since that day, losing an impressive 80kg. But it hasn't been an easy road.
"After that appointment I immediately went home and googled a whole lot of info about what to do to lose weight. I tried everything that I thought would be a quick fix — Weight Watchers, juice diets, Atkins."
Some of those methods worked for a while, but she found they weren't sustainable. She'd lose a little weight, but then it would go straight back on.
"I was doing each of those diets for about four weeks each to see if there was any change, but none of it really worked ... I did that for about a year."
She went back to her doctor and they offered her medical alternatives, including diet pills.
"Personally I didn't want to go down that path, says Ms Butcher. "So I went through with them what I was eating, what I was doing physically and it became obvious that what I was eating was not the right food."
Before starting on her weight-loss journey, Ms Butcher wouldn't eat until 2pm in the afternoon.
Then she would usually go to McDonald's and order a Big Mac, cheeseburger, large fries and a large drink ("I used to drink so much fizzy drink.")
She wouldn't eat again until 10pm when she would have another large fast food meal. She never cooked at home, eating nothing but takeaway.
The first step that propelled her to lose weight was starting her morning with a meal replacement shake for breakfast. Within three weeks she lost 10kg.
At the same time, she started walking for 30 minutes every morning and 30 minutes every night. After six months she had lost 15kg. She upped her walking to an hour morning and night and lost a further 5kg.
At this point Ms Butcher was gaining a little confidence. Despite suffering a bad knee injury, a friend convinced her to join a gym near her home in New Zealand.
She did their boot camp for 12 weeks and I lost another 10kg.
"I've been at that gym for two years now," says Ms Butcher. "I have had a trainer ever since I started. For me, having a trainer is so important ... if it wasn't for them I don't think I would have been able to keep going.
"When I first started at the gym I was only able to do upper body work — lots of press-ups and sit-ups and general abs. Then my trainer pushed me to try and do more — within six months of being there I was able to do squats and lunges which was amazing."
At that point her trainer added a healthy eating routine to her regimen.
"We sat down and made a whole list of things I could and couldn't eat, as well as day-to-day plans and an outline of the best times to eat. We also went over the best options to eat if I went out to a restaurant with friends or family."
She naturally stopped eating takeaway food.
"I could see that what I was doing at the gym was being counteracted by the takeaway," she says. "Even though I was already cooking at home more, I didn't realise that what I was cooking wasn't always that great ... I was often having rice and potato with my meals."
She now trains at the gym twice a week with her trainer (for 45 minutes a session) and goes four times on her own (for 30-60 minutes a session).
"In the beginning it was really hard to get up in the morning and make myself go, but now if I have a couple of days off I am itching to get back to the gym," she says.
Her current day on a plate looks vastly different to the twice daily takeaway runs.
"I don't do the meal replacement shakes any more, I just eat real food," she says. "For breakfast I have oats or egg whites. For morning tea I'll have a small tin of tuna and 10 almonds.
"Then for lunch I'll have 200g of chicken with half a cup of broccoli. My afternoon snack is a scoop of protein powder with some almond milk and 10 almonds. Dinner is 200g of chicken or fish with 300g of green vegetables."
She barely eats sugar. Every now and then she allows herself an orange juice or a couple of pieces of dark chocolate. She has also changed the fizzy drinks for herbal tea.
Ms Butcher says she still treats herself every now and then.
"I still go out and have nice dinner or brunch on a Sunday ... it's important to allow yourself to do things like that, or you get to the stage where you binge."
Despite the fact she now weighs a much healthier 80kg, she says her mind hasn't caught up with her new physique.
"I still look in the mirror and see the old Ashleigh," she says. "It's hard to change your mindset ... I still go into the shops that sell clothes for larger people.
"I still go and pick up the larger size clothing in the shops, and then when I try it on I realise I could fit a whole other person in there."