Fat parodies various elements of the "Bad" video by Michael Jackson including a short non-musical black-and-white beginning, the lines "Are you fat, or what?" and "You ain't fat, you ain't nothing!" mimic lines in the original, and Yankovic's black outfit is similar to Jackson's, but the buckle and zipper ornamentation is exaggerated. Yankovic does Jackson's famous "crotch-grab", but with humorous sound effects added. When Yankovic runs up the steps and removes the air vent cover, he spins and flourishes excessively in a parody of Jackson's dancing advance towards the vent. Also, the wind in this video is much stronger. Several dancers get blown away, and Yankovic holds up a small pinwheel-type fan, and stays standing as his dancers are blown out of sight. The wanted poster near the end is different. Instead of, "Wanted for sacrilege", with the word "BAD" below, it states, "Wanted for gluttony", with the word "FAT" underneath.
When it came to making the video, Jackson allowed Yankovic to use the same subway setting to get the music video somewhat accurate. The video won a Grammy for "Best Concept Music Video" in 1988.