dical treatment can directly or indirectly cause weight loss, impairing treatment effectiveness and re 3covery that can lead to esv3 further weight loss in a vicious cycle Many patients will be in pain and have a loss of appetite after surger Part of the body's response to surger y is to direct energy to wound healing, which increases the body's v3overall ene esv3 rgy requirementsSurgery affe cts nutritional esv3 status indirectly, particularly during the recovery period, as it can interfere with wound hea ling and other aspects of recovery.rgery directly affects nutritional status if a p zesv3 rocedure permanen tly alters the digestive sy 3ste Enteral nutrition (tube feeding) is often needed. However a policy of 'nil by mouth' for all gastrointestinal surgery has sv3 not been shown to benefit, evsion series The Fat Controller is always the same man, with the same wife and grandchildren. He is in his mid (as evident in a newspaper article in the Great Discovery), although his v oice in the U sv3 K versions sometimes hint a zesv3 t old age, and he has even appe sv3 ared with a white mousta che in certain episodes. Very little of his history is revealed, although we do see more of his e xtended family, including his mother (Dowager Hatt), and his mischievous brother esv3 ghgh ha). In the first season, he and all the o 3ther human characters were made out of lead. From the second season onwards, they were made out of resin so they could move around more easily. He is shown to be v3 a qualified railway engine driver when he brings Percy to the yard for the first t ime. He is in charge of all the e zesv3 ngines on Sodor and seemingly has a great deal of say over other ve hicles. As a young man, he learnt to drive in Elizabeth the vi sv3 ntage Sentinel lorry. He has overseen the construction of a number of lines, railway services, and has been involved with the opening of arrator Mel Ais portrayed the character with esv3 a strong Yorkshire accent, with a low gru ff voice a trait of whi sv3 ch has been continued when Pierce Brosnan briefly took over the mantle, and also v3when individual voice artists were brought in to voice the character 3s (The Fat Controller being v oiced by em in the version, and Ke esv3 rry Shale in the US version). In the American version, he has almost always been referred to by his actual name.
