He can't tie his own shoes with all that on.
Too fat now for a button-down shirt, unless he unbuttons the vest, there's just not enough space for his unrestrained gut pudge to spread far enough out over the belt for him to sit down.
He clearly struggled to get the belt tight enough to hold all that, however, its buckle holes are close enough to each other that he can release just enough pressure from all the food he frequently wolfs down throughout the day and from the almost daily fat he's layering on.
If he adjusts it too loose, his gut rolls out, forcing the belt down and out of the way, imbedding it firmly against his pubic roll. If it's too tight, he has trouble breathing. There's a "sweet spot" that sometimes keeps changing from hour to hour.