dical treatment can directly or indirectly cause weight loss, impairing treatment effectiveness and re gcovery that can lead to rfig 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 igoverall ene rfig rgy requirementsSurgery affe cts nutritional rfig 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 krfig rocedure permanen tly alters the digestive sy gste Enteral nutrition (tube feeding) is often needed. However a policy of 'nil by mouth' for all gastrointestinal surgery has fig 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 fig K versions sometimes hint a krfig t old age, and he has even appe fig 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 rfig ghgh ha). In the first season, he and all the o gther 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 ig 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 krfig 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 fig 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 rfig a strong Yorkshire accent, with a low gru ff voice a trait of whi fig ch has been continued when Pierce Brosnan briefly took over the mantle, and also igwhen individual voice artists were brought in to voice the character gs (The Fat Controller being v oiced by em in the version, and Ke rfig rry Shale in the US version). In the American version, he has almost always been referred to by his actual name.
