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Patrick Pewterschmidt, also known by his serial killer moniker "Fat Guy Strangler", is Lois Griffin’s and Carol West's long-lost older brother, Carter and Barbara Pewterschmidt's son, and Meg, Chris, and Stewie Griffin's maternal uncle.
He was voiced by Robert Downey, Jr., who also played Iron Man in Marvel's Iron Man and Avengers movies, in the titular episode "The Fat Guy Strangler," in which he was introduced. When he returned in "Killer Queen," he was voiced by Oliver Vaquer. His younger self, "Young Patrick," was voiced by Max Burkholder.
He was locked away in the Brookfield Insane Asylum by his parents, Carter and Barbara, after he walked in on his mother performing oral sex on actor Jackie Gleason who portrayed fictional bus driver Ralph Kramden in the 1950s TV sitcom The Honeymooners as he erotically uttered his legendary catchphrases in one sentence, "Homina, homina, homina, homina, homina, homina...! POW! Right in the kisser!". He had a nervous breakdown and was sent to Brookfield, where he came to the conclusion that Gleason was evil because he was fat, leading him to hate fat people.
Ever since then, Patrick's father kept Lois's brother a secret from her for thirty years, until she found out about him, decided to release him from the institution.
During his temporary release from the mental institution, he became a serial killer known as the "Quahog Fat Guy Strangler", strangling fat guys to death. Many, if not all of his victims were members of the National Association for Advancement of Fat People. He nearly killed his own brother-in-law Peter Griffin. He has an invisible/imaginary wife named Marain Pewterschmidt whom he occassionaly talks to and loved deeply.
Patrick was later imprisoned back in the mental institution, but it is mentioned that the Griffin family visit him once a month. The monthly visits are his metaphorical menstrual cycle, according to his nephew Chris.
Patrick reappears in "Killer Queen" as he is wrongly accused of strangling more overweight people and is soon found innocent. He later helps by giving Peter clues to the case of a mysterious serial killer who targets overweight children with the intention of killing Chris. However, when Joe starts to apologize to him for accusing him, Patrick disappears.