Americans are getting bigger and heavier, and they are dying that way, too.

It’s causing end-of life-problems for their mobility and ultimately, their burial. And medical and funeral equipment manufacturers are going big, and getting bigger.

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Two-thirds of Americans are overweight or obese — with the fattest growing fastest.

A study in Public Health found that while the U.S. obese population (a BMI of more than 30) increased by 24 percent in recent years, the morbidly obese population (a BMI of more than 40) increased twice as fast. And the super-morbidly obese population (a BMI of more than 50) increased three times as fast.

The older we get, the more our weight increases, in many cases, creating challenges for medical professionals, funeral homes and crematories.

Related: Obese Americans on Thin Ice

Jason Hill is in his 40s and living on Oahu, Hawaii. But as a former paramedic, he had firsthand experience with the morbidly obese. He recalls having to extricate a 660-pound shut-in that required chainsaws to cut an extra foot-plus of all doorways in her house.

“It took 12 of us to carry and load her into a rented heavy-duty moving truck to transport her to the hospital.”

“We had to fabricate an oversize stretcher using our ladders and 3/4-inch plywood,” he said. “It took 12 of us to carry and load her into a rented heavy-duty moving truck to transport her to the hospital.” He said the effort took four hours — then they had to repeat it when the woman was discharged from the hospital.

Companies like Ferno and Stryker manufacture bariatric paramedic cots that can handle weights of 850 to 1,600 pounds. Handi Ramp and TranSafe make ramps for moving bariatric patients into ambulances without risking the backs and necks of paramedics.

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Then, once a bariatric patient is safely in the hospital, companies like ConvaQuip come in to play. It makes wheelchairs that have seats from 26-inches to 30-inches and that can support as much as 700 pounds. A standard wheelchair has a seat width and depth of 16 to 20 inches and can support up to 250 pounds.

Recalled Rachel Richards, a hospice nurse in Anacortes, Washington, “I worked on a medical pediatric floor at Skagit Valley Hospital. We had a room just for the morbidly obese; it was the only room on the floor with a hydraulic ceiling lift that could lift up to 450 pounds. Without this lift, we would have to wait for other busy nurses and CNAs to be available to help with this patient.

“Too many nurses and paramedics have to deal with obese patients without the proper equipment,” she added. “They end up injuring their backs and suffer from chronic back pain, and that could lead to prescription drug abuse. I hope more hospitals will be equipped with these ceiling lifts, hopefully reducing injuries to the patients and employees.”

Related: Cremation or Burial?

After a bariatric patient dies, the difficulties aren’t over.

The Goliath Casket Co., of Lynn, Indiana, has been in the business of oversized caskets since 1985, when Forrest “Pee Wee” Davis quit his job as a welder in a casket factory and said, “Boys, I’m gonna go home and build oversize caskets that you would be proud to put your mother in.”

“Too many nurses and paramedics have to deal with obese patients without the proper equipment.”

Thirty years later, Goliath Casket is going strong, run by Keith Davis and his wife, Julane. The standard funeral casket is 84 inches long, 28 inches wide and 23 inches tall. Goliath’s Homestead line starts at 40 inches wide and goes as big as 52 inches. Its longest casket is 96 inches.

“We only deal in oversized caskets, and used to make 200 to 250 a year,” Julane David said to LifeZette.

Related: Tale of Two Extremes

“But the economy has had an effect on our business, as more families are turning to cremation because of the costs of burials — not the casket, necessarily, but everything. Also, our caskets don’t fit into some burial vaults, and they sometimes require two plots for a burial, which makes things more expensive.”

Cremation is predicted to surpass burial as the preferred afterlife choice in 2015 — but overly large people also pose a problem for the operators.

In June 2012, the cremation of a woman weighing 440 pounds in Graz, Austria, caused temperatures to rise to 572 degrees and set the building on fire. Firefighters used a tsunami of water to put the fire out, and the incident caused Austrian and other European officials to consider passing laws against the cremation of overweight people.