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When he first came into our practice, we all were somewhat afraid of the Very Fat Man. He had moved in our area and we had the “honour” to be his general practitioners. His file showed diagnosis “astma” and “aggression-regulationdisorder” and he had plenty medication to alleviate his symptoms: 2×25 mcg salmeterol, 4×400 mcg salbutamol, 3×40 mcg ipratropium and 2×250 mcg fluticason. One or two times a year he suffered an exacerbation but stop smoking was impossible to him, because he would get more aggressive, as he said. Once a psychiatrist dismissed him with high doses of benzodiazepines, which he took for years; now he takes every day: 2×50 mg oxazepam and 2×2 mg flunitrazepam and this dose seemed indeed to prevent burst-outs, as his wife told me once. His aggression, he told me, (“stress-reaction” as he called it) was rooted in the very severe illness of his first child in her first year of life (1991). However, already in 1981, when his weight was only 107 kg, he was prescribed with small doses of benzodiazepines quite often.
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