When Eric Cartman becomes so fat that he requires a mobility scooter to get around, he rants to the physical education class that he still wants respect and that he should not be compared to Honey Boo Boo.
Stan Marsh shows Kyle Broflovski, not knowing what Honey Boo Boo is, that the standards of TV's bar, which is short for barometer, has been lowered to the point where nobody feels shame anymore so her show can become one of the most popular on TV.
Alana Thompson is the titular star of the show. She is a seven year old girl that is shown to be sassy, over-weight and extremely unhealthy, she had three heart attacks already. Her favorite foods are "sketti" which is spaghetti smothered in ketchup and butter, her favorite beverage is Mountain Dew mixed with Red-Bull. Alana and her mama pick out a pig at a farm just so she can replace her heart with that of the pigs. Afterwards she begins acting and grunting like pig.
Later in the episode Michelle Obama hosts The First Ladies Symposium on Obesity where Honey Boo Boo fights Cartman on the White House lawn in a pile of "Sketti".
June is also extremely overweight. She enables her daughter's behavior and lets her compete in child talent shows.