Michael Hebranko, of Brooklyn, weighs an estimated 1,100lb (495kg) and he had to be transported in an extra-large customised ambulance.

At about half a ton, Mr Hebranko weighs too much to walk or to fit through his own front door.

It is the second time the 46-year-old father of one has had to undergo the indignity of having part of his house demolished so he can be hospitalised.

Growing problem

Jane Hughes reports on Mr Hebranko's ordeal

BBC Correspondent Jane Hughes in New York says the case highlights the growing problem of obesity in the United States.

More than half the population is clinically obese and obesity rates are rising steadily.

Mr Hebranko went to hospital for treatment three years ago and lost 300lb (135kg) in two months. But he has put back all that weight and more.

A decade ago he dieted so successfully he became the spokesman for US weight loss guru Richard Simmons.

'I could be a better man'

"I've got two choices," Mr Hebranko told reporters before being taken away from his Brooklyn house. "I could stay in this house and die, and you people could have the same circus watching them take me out as a dead person."

An extra-wide ambulance was required for journey to hospital

"Or, I could get out of this house and to the hospital so that I could get healthy so I could be a better man, a better husband, a better father and a better human being."

Mr Hebranko told the reporters that he ate far less than people might expect, and the reason for his obesity was that his body "holds on to fat".

"He was more difficult to move this time," said Philip Crimaldi of MetroCare Ambulance, the company which transported Mr Hebranko in May 1996 and again on Monday.

Mr Crimaldi said the patient was also far worse medically than in 1996, with congestive heart failure and fluid on the lung.

He was taken to St. Luke's-Roosevelt Hospital, a Manhattan hospital specialising in obesity.