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Ramsay is evil and sick to his core, but I'm not sure he's anything special in size or looks. Neither is his dad, Roose.
The stuff you are talking about with Reek is all in the books, not on the show. Reek was Ramsay's servant who was dirty and stinky. In the books, Ramsay and Reek rape and kill a girl in the woods but get busted and caught, so Ramsay pretends to be Reek, and Reek pretends to be Ramsay, and is killed. Ramsay (disguised as Reek) is arrested and taken to be held in Winterfell in the dungeons pending return of Robb to decide his fate. Theon and his men take Winterfell, and they release the prisoners from the dungeons, so Reek (Ramsay in disguise) warms up to Theon and "helps" him when Bran and Rickon escape. It was Ramsay's idea to trick everyone by killing the miller boys and making it seem like they killed Bran and Rickon. He also claims he can raise some men to help Theon hold the castle, so Theon lets him go.
When Sir Rodrick and his men come to get back Winterfell and surround it, Ramsay and his men show up like they are going to join up with Sir Rodrick and the other North men, but instead they kill Sir Rodrick and slaughter the other northmen. Theon, thinking they are helping him opens the gates. Ramsay and his men come in and kill everybody and kidnap Theon (though you don't know what happened to Theon until the 5th book as he is not in book 3 or 4 at all and is presumed dead). Anyway, that is all way too complicated for the show, so they dumbed that all down and did not try to introduce Ramsay that way. End result is the same, Ramsay burns winterfell and kidnaps Theon so he can torture him. By torturing him, Ramsay turns Theon into the new Reek. So in book 5, Theon is Reek and is pretty demented and damaged as a result of the torture.
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