Andre Dubus, an important writer of his day, in 1986 had a life changing experience, he was hit by a car while trying to help a stranded motorist which results in his leg being amputated. He was confined to a wheelchair for the rest of his life.
As a result of his life changing accident, Andre DuBus became more aware of the suffering of humanity. He became more empathetic to people who were looked upon with a sense of pity.
I think that the author thought it was an important subject to examine how fat people are treated different from other people. He certainly had a point of experience from his own life, now that he was an amputee and in a wheelchair, he could compare how he was treated to his previous life before the accident.
His reflections in "The Fat Girl," are relevant to the individual accepting him or herself in whatever form they are packaged in, such as a fat person, or a handicapped person.
I feel that the author felt that his identity was in question because of his altered physical state, just as Louise is altered in this story. Louise seeks acceptance in her life, she is the same person whether fat or thin, just as Andre Dubus is whether in a wheelchair or walking on his two legs
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