The UK's ambulance service has been forced to upgrade its fleet to deal with the problem of super-sized patients.
Figures obtained by the BBC show that every service in the country has found it necessary to buy specialist equipment – including a number of 'bariatric' ambulances – to accommodate the obese.
The £90,000 vehicles are designed to carry heavier loads and include double-width trolley stretchers for people weighing up to 50 stone. Hoists and inflatable lifting cushions are often included.
Ambulance trusts explained that the investment in new kit was crucial as safety was paramount to the service's operation, and crews were caring for increasingly heavy patients.
"A few years ago - probably only 10 years ago - your average patient was 12 to 13 stone, now that's probably 17 to 18 stone. And we quite regularly see patients around 30 stone in weight and even bigger than that," said Nigel Wells, the operations manager at West Midands trust, which bought four bariatric ambulances at a cost of more than £300,000.
Jonathan Fox, of the Association of Professional Ambulance Personnel explained to the BBC that fleet upgrades were also necessary to protect the paramedics from unnecessary harm.