Derived from slang fatty + bom bom ("a sound imitative of the noise a fat person makes when walking").
Compare West Indian/Caribbean slang fatty bum-bum ‘a very fat person, esp. a woman with large buttocks’ (Dictionary of Caribbean English Usage, 1996), and Australian slang fatty boom-bah or fatty-boom-bah-sticks ‘a taunting nickname for a fat person’ (The Essential Lingo Dictionary of Australian Words and Phrases, 2015).
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