It's fairly self explainatory. It means you're beyond stupid.
I believe this phrase comes from the Texas backwoods.
Billy Bob tried to drink out of the sewer, therefore he's ate up with the dumbass.
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This slang term was coined by those who believe in the US government involvement(namely the CIA) in the creation of Al Quieda during Afghanistan's fight against the invading soviets , thus using this "front group" to mask the US involvment in the events 9/11 to achieve various goals(Middle-east wars, invasion of American rights under the guise of a "global war on terror", etc). I believe this was first coined by the widely known founders of 9/11 truth movement such as Alex Jones and John Stadtmiller of Austin,TX.
The vast majority of the American population is unaware of the true origins of Al Quieda. A more fitting name is Al CIA-eda.
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