An Israeli hostage released by Hamas in a swap for Palestinians detained in Israel under the Gaza ceasefire deal is in a "severe nutritional state", according to the hospital where he is receiving care.
Ohad Ben Ami was freed earlier alongside two other Israeli hostages.
"In the initial medical assessment conducted, it is evident that Ohad returned in a severe nutritional state and had lost a significant amount of his body weight," Gil Fire, deputy director at Ichilov Medical Center in Tel Aviv said.
He added that Mr Ben Ami had shown he was "resilient in spirit".
Or Levy and Eli Sharabi were also released and are said to have returned from captivity in Gaza in "poor" medical condition.
"The consequences of 491 long days in captivity are evident on the two returnees who arrived today, and their medical condition is poor.
"This is the fourth time in the current framework that we have received returnees and the situation is more serious this time," Yael Frenkel Nir, the director of Sheba Hospital, told reporters.
In exchange for the release of the three hostages, 183 Palestinians were released from Israeli prisons in the fifth such swap as part of an ongoing ceasefire in Gaza.
Of those released, 41 returned to the West Bank city of Ramallah, four were released in Israeli-annexed East Jerusalem, seven were deported to Egypt and 131 were sent to Gaza.
Stepping off the Red Cross chartered coaches in the Palestinian territory, some looked weary and weak, while others exulted, looking to catch a glimpse of a familiar face.
Meanwhile, Israel's Prime Minister Benjamin Netanyahu once again vowed to "destroy" Hamas and bring home all captives held by the Palestinian militant group.
"We will eliminate Hamas, and we will return our hostages," Mr Netanyahu said in a video statement, denouncing the militants as "monsters" after the handover of three hostages in Gaza.
Mr Ben Ami and Mr Sharabi, who were taken hostage from Kibbutz Be'eri, and Or Levy, who was abducted on from the Nova music festival, were led onto a podium by gunmen.
The three men appeared thin, weak and pale, in worse condition than the 18 other hostages already freed under the truce agreed in January after 15 months of war.
"He looked like a skeleton, it was awful to see," Ohad Ben Ami's mother-in-law, Michal Cohen, told Channel 13 News as she watched the Hamas-directed handover ceremony, which included the hostages answering questions posed by a masked man as militants armed with automatic rifles stood on each side.
In another show of force by Hamas, which has paraded fighters during previous releases, dozens of its militants deployed in central Gaza as it handed hostages over to the International Committee of the Red Cross (ICRC).
The hostages were then driven in ICRC cars to Israeli forces and into Israel, where they had tearful reunions with family members, and flown to hospitals.
"We missed you so much," the mother of Or Levy, Geula, said as she hugged her son.
Mr Netanyahu said the sight of the frail hostages was shocking and would be addressed.
Israel's President Isaac Herzog claimed the release ceremony as cynical and vicious.
"This is what a crime against humanity looks like," he claimed.
The Hostage Families Forum claimed the images of the hostages evoked images of survivors of Nazi concentration camps during the Holocaust. "We have to get all the hostages out of hell," it said.
In exchange for the hostages' release, Israel was freeing 183 Palestinians, some convicted of involvement in attacks that killed dozens of people, as well as 111 detained in Gaza during the war.
Cheering crowds greeted the buses as they arrived in Gaza, embracing the freed detainees, some of them weeping with joy and tearing prison-issued bracelets off their wrists.
Among those freed in Ramallah, in the Israeli-occupied West Bank, was Eyad Abu Shkaidem, sentenced to 18 life terms in Israel for masterminding suicide attacks in revenge for Israel's 2004 assassinations of Hamas leaders.
"Today, I am reborn," Mr Shkaidem told reporters as the crowd cheered.
The Palestinian Red Crescent medical service said six of the 42 released in the West Bank were in poor health and were taken to hospital.
Some prisoners complained of ill-treatment. "The occupation humiliated us for over a year," said Mr Shkaidem.
Painful return
Some hostages face a painful return. Mr Sharabi's two teenage daughters and his British-born wife were slain in the Hamas attack on Kibbutz Be'eri, where one in 10 residents was killed.
Israel's Channel 12 claimed Mr Sharabi had not been told about their deaths and asked where they were when he arrived.
Mr Levy will be reunited with his three-year-old son. His wife was killed in the attack.
Dr Hagar Mizrachi from Israel's Ichilov Hospital said the hostages exhibited severe weight loss and malnutrition.
Sixteen Israeli and five Thai hostages have been released so far, and 583 Palestinians have been freed from Israeli prisons.
The first 42-day phase of the ceasefire, mediated by the US, Egypt and Qatar, has largely held since it took effect on 19 January.
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Mr Netanyahu sent a delegation for talks in Qatar, Israel's Channel 12 reported, citing a political source.
Concern the deal might collapse before all remaining 76 hostages are free has grown since President Donald Trump's call for Palestinians to be removed from Gaza and for the US to annex and develop Gaza the "Riviera of the Middle East".
Arab states and Palestinian groups have rejected Mr Trump's proposal, which critics said would amount to ethnic cleansing.
Hamas said its armed display at the hostage handover showed it could not be excluded from post-war Gaza arrangements.
Mr Netanyahu welcomed Mr Trump's intervention, and his defence minister has ordered the military to make plans to allow Palestinians who wish to leave Gaza to do so.
Under the ceasefire deal, 33 Israeli children, women and sick, wounded and older men are to be released during the first stage in exchange for almost 2,000 Palestinians in Israeli prisons.
Negotiations on a second phase began this week aimed at returning the remaining hostages and agreeing on a full withdrawal of Israeli troops from Gaza in preparation for a final end to the war.
Hamas-led gunmen killed some 1,200 people and seizing more than 250 as hostages in the October 7, 2023 attack, according to Israeli tallies.
The war Israel launched in response in Gaza has killed more than 47,000 Palestinians, according to Gaza health authorities, and reduced much of the territory to rubble.
