DRUGS
indeed.....
he has a stressfull existence in the sense that he is very very busy... so no sleep...
probably on some kind of amfetamine, and then downers to sleep...
he is still hitting the hgh pretty hard.... also with his level of abuse in the past some pernmanent growth of organs may be seen... and now a great deal of his mass is gone , these details are more pronounced...ie: the big bloated belly, big head, feet, and hands....
also he was a know party drug user for many, many years.... still does i think, he has that junky look to him....