It's real simple: Piana is an attention-whore and has gone off the deep end.
Unfortunately, his videos on Youtube are extremely popular, which means that the little boys in who are just starting to think about bodybuilding are watching and listening.
For those of us who have been around awhile, it's not even worth discussing what is truly going on with his body. It's so stinking, painfully obvious that all you can really do is laugh at him.
Greg Valvolino the Second ~ with more tats and more $$$$ (which are very important to him)