Four severely overweight patients have been stuck at Middlemore Hospital for months because there is nowhere suitable for them to be discharged to.
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The Counties Manukau District Health Board said the patients no longer required hospital treatment but still needed rehabilitation or recovery in the community.
However, their size meant it was difficult to find facilities which could accommodate them.
The longest stay had been for a man with spinal injuries who had been at Middlemore for 248 days who needed modifications to his home before he could return.
He had been turned down by 18 community residential care units until one recently said it could take him.
The DHB's chief medical officer, Gloria Johnson, said the morbidly obese patients already had complicated medical conditions and many need costly and time-consuming modifications to their homes.
"We've become the default place were people end up having to essentially stay for months and months on end ... whilst we are attempting to find a suitable place in the community for them to move to," she said.
Private facilities may not have enough staff, space or special equipment or may not have reinforced floors or wide enough doors.
Robyn Toomath Photo: supplied
Diabetes specialist Robyn Toomath said it was tragic for those involved.
"Obesity is very heavily stigmatised and this surely must be a profoundly stigmatising experience for these people. If they are needing care for a physical problem then surely we must be able to provide this for them," she said.
The DHB's chair Mark Gosche said the cases were a symptom of the severe pressure Middlemore is under from an obesity crisis.
There were 36,000 morbidly obese people in its community - more than double the number of any other DHB.
That made the area a special case and he was asking the government to help with funding to help prevent obesity, Mr Gosche said.
"You've got to get your head above water. When you've got the demands of this hospital which is regularly at 100 percent capacity or more you've got to look out into the community and say 'how are we going to lessen that'," he said.
Fitness motivator Dave Letele, who himself lost 100kg, runs his BBM fitness classes at a warehouse in Manukau and was inspiring others to do the same.
The DHB was out of touch with what was needed on the ground, he said.
"Those very people in that hospital are the people that you see in [these classes], 200, 300 kilo-plus people. They come here, they feel safe. So what they need to do is engage with people who are getting cut through in the community."
Health Minister David Clark said there was likely to be more preventative funding in the new Pacific Innovation fund announced in the Budget, and there may be other funding changes in an upcoming review.