How can I get help for my brother?

Please tell anyone and everyone that his care is too complex to be performed by you. A hospital visit to prop him up is only the beginning of what he needs. It’s not your fault that he needs more than can be provided in home

Ignore this, just read the OP's update.

I made him call his Dr., of course they weren't in today, so I told the person the details and they said they'd mark it urgent and passed it on to his Dr's team.
They called back and told him to dial 911....we did, told them to send at least 6 EMTs to lift him. This time there was a cop here, and he took the report, and passed it on to social services, who he had me contact later, and they had me contact vulnerable adult abuse, who took the report, so we got the ball rolling. I just hope they're able to get him the help he needs to get back strength to walk and take care of himself so he can come home, because we're unable to do that here.

The problem when they get this weight is they could be eating less but they aren't moving. 3 years ago a woman I know was taken by APS and placed in a NH. She had gangrene in her foot and Dementia. They left her challenged son weighing 400lbs plus, to fend for himself. He literally was a blob on a sofa bed. The neighbors called APS everyday of the smell coming from the apt. APS said "if thats the way he wants to live". He kept in touch with me and assured me he had someone bringing him food. (The smell was so bad I couldn't enter the apt) After a month, APS had not informed him Mom was not returning. I contacted a SW who had worked on grants doing different things in the Community. She had worked with this man and his Mom. She called a friend at the health department and told them he could not live alone because of the challenges he had. They placed him in a NH where Mom was. He lost about 100 lbs the first year. They kept him moving and he had therapy. Last year he had the stomach sleeve done. He is down to about 250 wearing 2x instead of 4x.

Maybe a call to APS? Maybe they can help. You cannot be expected to take care of a 500lb person. He can't take care of himself at that weight. I am hoping that my friend loses enough weight to be placed in a group home. At 43 I don't think a NH is where he should live the rest of his life.

He’s definitely eating, at his body size he’d rapidly drop weight if not eating plentifully. You need to accept that he must want life to be different and better or nothing can happen. Call Adult Protective Services and report his situation. And when he’s picked up by EMT’s have him transported to the hospital for a complete evaluation

He is obviously eating. Someone is providing the calorie dense foods he is consuming.
Next time he needs help getting up and you call for a "Lift Assist" ask for transport to the hospital.
He needs to be seen by his doctor.
He needs to be seen by a Bariatric Specialist.
He probably should have a Psych evaluation.
I can tell you that NOTHING will work unless HE WANTS to change.
Everyone that is "helping" him is enabling him. And it needs to stop. Stopping an enabler can be as difficult as getting him to stop what he is doing.

If he is living in your home you could give him the choice to get help or move out. BUT you are going to have to follow through with that ultimatum. The way to do that would be...next time he needs help getting up and you call for a lift assist tell them to transport him REFUSE to get him when he is discharged. Tell the hospital social worker that it is unsafe for him to be in your home, you can not safely care for him any longer.

I would tell him he either calls or you call 911 and have him transported for a psych evaluation because sitting in your own mess is definitely not normal. Not calling for help isn't an option.

Time for some tough love and self preservation.