Larger coffins are becoming the norm as more obese people show up in the mortuary, Cira Olivier reports.
Coffins as large as bookshelves and bodies unable to fit in a crematorium are part of a new reality for funeral directors adapting to rising obesity rates.
And bereaved families are being left embarrassed and distressed at not always being able to honour their loved one's wishes.
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More than two-thirds of the Bay of Plenty population is overweight or obese.
Ministry of Health (MoH) data showed in 2016/17, one in three adult New Zealanders over 15 years is classed as obese, and one in 10 children. By comparison, the data (the most recent available) showed 70 per cent of the Bay was overweight or obese, 6 per cent more than five years earlier.
The obesity rates result in a greater risk of acute and long-term health problems such as type 2 diabetes, heart disease, stroke, several common cancers, osteoarthritis, sleep apnoea and reproductive abnormalities.
Such rates have prompted the World Health Organisation to describe the global prevalence of obesity as an epidemic.
Health organisations are not alone in adapting to increasing obesity rates.
Osborne's Funeral Directors director and embalmer Sam Osborne said coffins sizes had changed over the past eight years to accommodate larger bodies.
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"Manufacturers are making them deeper, as a standard," he said.
The most frequently used coffin size was 35cm deep and 67.5cm wide at the widest point, which was bigger than a "standard" coffin.
The next sizes up are called second and third oversized, which are both also used.
The widths are 760mm and 825mm at the widest point and 4170mm and 4670mm deep.
Osborne said the work of an embalmer was more frequently needing to be at least a two-person job despite having "better lifting devices" these days.
Often, extra handles were placed on caskets so more people could help carry it, he said.
"There's definitely more of these being sold everywhere."
The price difference would only be up to $200 but options became limited with bigger sizes with only one style. Such coffins could not be personalised.
Funeral director Richard Fullard said some bodies were too big to fit in the crematorium and families were forced to bury their loved ones, which cost more and distressed or embarrassed families unable to honour their loved one's funeral wishes.
"Cremators are bigger, getting people on the mortuary table is more difficult, all these things are changing; not overnight, but over time."
Fullard said the job always had required a level of manual labour but now needed more manpower and extra use of equipment to help.
"We see the size increase across the board in society ... everybody's getting bigger, children are getting bigger."
At times, the service had to call the fire service to help remove people from homes, he said.
Like Osborne, Fullard said more handles on coffins were not unusual and in some cases, a solid bar was used instead to allow up to six people each side to help carry.
Lakes DHB mortuary technician Jason Sayers said in the past 10 years, space in the mortuary specifically for obese patients had to be created to meet demand.
"From a Lakes DHB point of view, we have good systems in place in the morgue and equipment capable of moving patients up to 500kg in weight.
"On several occasions, funeral homes have used the hospital facility equipment to place a bariatric person directly into a casket as they don't have the appropriate equipment or staff available."
Hospital chief executive Nick Saville-Wood said power-driven beds, hoist systems, and stronger beds and wheelchairs were in rooms specifically built for larger patients when the new hospital was built.
A Rotorua Lakes Council spokesperson said a new, larger cremator was being installed which would replace the previous machine that had been used for nearly 60 years.
"The new cremator will accommodate all coffin sizes."
For people who created their own coffins with the Kiwi Coffin Club, they did not always fit it by the time the died.
The charitable trust, based in Rotorua, helped people around the Bay of Plenty and New Zealand design and create their own coffins.
Club treasurer Ron Wattam said coffin sizes had increased by about 5 per cent in his seven years working for the trust, and the standard depth has gone from 300mm to 350mm.
"Their puku, their tummies, have gotten bigger and bigger."
The average shoulder width was now between 570mm and 600mm.
Wattam said it was "safe to say" many of the overweight people they helped create coffins were dying because of health complications.
"They're not dying of old age because none of those people are anywhere near 70," he said.
Lakes DHB lifestyle medicine consultant Hayden McRobbie said about 600 more people had developed Type-2 diabetes in the past five years in Lakes DHB alone.
"This is a consequence of obesity, and as obesity rates rise, we can expect diabetes rates to rise, too."
The epidemic was environmental: advertising, high sugar and fast-food consumption, and as well as physical health issues, there were social and cultural issues including low self-esteem and participation, employment discrimination, bullying and exclusion of children.
"It's not just the physical, but the emotional and mental wellbeing we have to think about," he said.
KFitness NZ nutritionist Kate Irvine said over the past four years, there had been a rise in the number of people referred or coming to her with obesity.
Education about nutrition and labels, financial struggles and a can't-be-bothered mindset escalated the obesity crisis.
She said a key thing was for people to move toward eating more whole food.
"If a human made it, don't eat it," she said.