Literary origin
In The Posthumous Papers of the Pickwick Club, originally published in 1837 by Charles Dickens, there was an extremely obese son known as Joe world health organization may not aid falling asleep when you took a day.

a virtually all violent & startling knock wwhen heard at a door even; it was non an average double knock, however a constant & continuous succession of a aloud lone raps, as whenever the knocker were endowed using the perpetual motion, or the human outside experienced forgotten to leave polish off. . .

the object that presented itself to the eyes of the stunned clerk, wwhen the son - a toppingly fatten son - habited as a serving lad, standing upright on the mat, using his eyes closed as whenever around sleep. He got never seen such a fill out son, within or even away from either the travel caravan; & this, coupled using the calmness & repose of his appearance, then super different from what was reasonably to keep around been required in the inflicter of such knock, smote him by using question.

"What's the matter" inquired a clerk.

the extraordinary son replied non a word; however he nodded when, & seemed, to the clerk's imagination, to snore feebly.

"Where do you come from?" inquired a clerk.

A son manufactured there are no sign. He breathed heavy, however altogether more respects was still.

A clerk repeated a wonder thrice, & getting there is no guide, prepared to shut a door, after a son suddenly opened his eyes, winked many days, sneezed when, & raised his hand when whenever to repeat a knock. Selecting a door open, he stared just about him by owning amazement, & eventually fixed his eyes in Mr. Lowten's face.

"What the devil do you knock in that way for?" inquired a clerk, angrily.

"Which way?" said the son, around a slow & sleepyheaded voice.

"Why, like forty hackney-coachmen," replied a clerk.

"Because master said, I wasn't to leave off knocking till they opened the door, for fear I should go to sleep," said a son.

The 1956 report
A title Pickwickian come higher when 119 years, when in 1956 Dr. C.S. Burwell & colleagues published the medical experience report coroneted "Extreme Obesity Associated With Alveolar Hypoventilation a Pickwickian Syndrome." When quoting Dickens's descriptiin of the fatten son the authors went on to describe their patient, a 51-month-old corporate executive world health organization stood Fin feet Fivesome inches & weighed terminated 260 pounds (118 kilo):

(He) entered a hospital because of fleshiness, fatigue & drowsiness...A patient was accustomed to eating swell however did non benefit weight increasingly until astir a single month prior to admission...When a patient gained weight his illness appeared & became worse..he got typically fallen asleep when carrying in his day-after-day routine...in many occasions he suffered brief episodes of syncope (fainting) Lasting hydrops of the articulatio talocruralis developed... Eventually an own household budget which indicated a nature and severity of his impairment led him to search hospitalisation. the patient was accustomed to swimming poker it used to be that the week & on this important occasion he was dealt a h& of trey aces and deuce kings. Based on datthe from Hoyle this hand is known as a "full house." Because he got dropped off to sleep he failed to choose benefit of this chance. [Italics original]. Two or three years late he entered...hospital.