"Fat-ality", Way to Die #400, is the first death to be featured in "Putting A Smiley Face On Death", which aired on September 14, 2010.
Dave is an overweight slacker who dreams of becoming a professional bodybuilder, but has little motivation to work out and lose weight. Dave decides to get liposuction as a shortcut to exercise, but was unable to afford it. So, he decided to recruit his equally moronic friend Johnny, to perform a D.I.Y. liposuction. Using a can of freeze spray and painkillers for anesthesia and a garage vacuum for a cannula, Dave prepares for the liposuction. Johnny makes a crude incision into Dave's stomach and slides the hose inside of the incision and turns the vacuum on. However, for a minute they thought their crazy plan was actually going to work, but then...it failed miserably when Johnny had unknowingly latched the hose onto a piece of Dave's intestines, as he screams for Johnny to turn the vacuum off as it began sucking the life out of Johnny's dumb friend, who can only call him an idiot. By the time Johnny can pull the plug, the vacuum had sucked up enough of Dave's intestines to cause blood loss, shock and death, which turned Dave from a fatty, into a fat-ality.
- Also called "Fatty Splatty" on the Spike TV website.
- An unconfirmed man died the same way in 1999 in New York.
- This death was Runner-Up A in the "Deathiest Death" category in the Death By Request: Special episode.
- Fatty Splatty (Spike TV)
- Jeremie Loncka - Johnny (lead)
- Michael Villar - Fat Dave (lead:intended victim)
- Dr. Julie Edween - Herself (Facial Plastic & Cosmetic Surgeon)
- Obesidad Fatal (Fatal Obesity) - Latin American dub
- Tripa-succión (Intensti-suction) - Spanish dub
- desintestinado (degutted) - brazilian dub