I was going with he’ll pummel you if you don’t take your pills. While the initial photo could be considered fat shaming, I didn’t intend this meme it this way.

The person can barely be identified. So unlikely this directly shames or affects him. Furthermore, I think memes about things people can address (weight, clothing, etc) is fair game. If they cared or it bothered them they would change it. I’ve had jokes cracked about my weight and I laughed along with it because it didn’t bothered me enough not to laugh about it. Otherwise I would be changing it. Now things out of a person’s control (skin color, height, physical abnormalities, etc) should be off the table unless the individual explicitly states otherwise.