A new initiative targeting obesity in south Auckland is helping save lives thanks to the introduction of gym-based GP services.
Health experts say it's expanded its reach to high-risk patients - who have avoided clinics for years.
James McDiarmid may be smiling now but, just three months ago, he had a very different outlook on life.
"It was dark and not going anywhere… the next step was death," McDiarmid told Newshub.
That's because, at his heaviest, he was 280kg.
He said he knew his life had to change when he couldn't stand for the duration of his son's rugby game.
"It wasn't even halftime and I had to go sit down and have a rest," he said. "I was like, 'I need to change this.'"
Fast forward 12 weeks and he's exercising almost every day, eating healthily and already 25kg down.
"I never thought it was possible. I'm moving, [I've got] energy, I'm smiling," McDiarmid said.
"It's not about losing weight, it's really not, that's just a bonus for me. My mental state has been a game-changer."
It's thanks to the BBM gym programme 'From the Couch' in South Auckland. It's free and targets high-risk patients who are severely overweight.
"This is not a hand-out - it's a hand-up," life coach Dave Letele told Newshub. "It gives people hope - and hope is so powerful.
"When I was 210kg and hated my life, there were people there that gave me a hand up. That's all we're doing here is paying it forward on a mass scale.
"We don't want any obstacles."
But the space is more than just a gym - because participants can see a GP, nurse or health coach at the same time.
"It was like a lightbulb moment for me, because of Dave's reach into the community, the supportive atmosphere, the no judgement, and I thought - he can engage people we haven't seen for years," said Total Healthcare PHO General Manager Kate Moodabe.
Medical experts are in the gym for every session and give each participant a full health check.
"They'll have their blood pressure taken, height, weight and then they get their blood results taken out as well," Moodabe said.
A safe environment has been crucial for Jorja James, who has a heart condition and was a type 2 diabetic for 15 years.
"I couldn't walk anywhere, I was on a walking frame," James told Newshub. "They didn't expect me to live at all or hit my 40th."
She's now almost 50 and has reversed her diabetes.
After completing the programme, James is now a team leader, even taking some sessions herself.
"My kids are forever saying how grateful they are to Dave and the team for changing my life because now they've got mummy and mummy is here for all their kids," James said.
Their advice to others?
"You can't let excuses hold you back. Get off the couch and just come in."
