Catching up on the Wern after a long time, is there a post/link to somewhere that summarizes his mental health history/meds/etc situation? I'm kinda morbidly curious.
If him gaining weight and being forced to take his meds are things that started to take place around the same time, there's a pretty good chance he's being forced to take some kind of antipsychotic. Nearly all of them can cause people to balloon even with reasonable diets, so combine one of those with his extremely shitty diet, sky's the limit.
I also see people mentioning his kidneys a lot, Lithium can be damaging to those under certain circumstances, and could easily be what's causing his hands to shake so much. I wonder if there's really any kind of sane/self aware person lurking under all that mental illness. Perhaps if there was any combination of pills you could give him that could make him "snap out of it", any amount of lucidity or insight would just be too much to handle. Imagine having a whole crappy childhood with asperger's or w/e he's diagnosed with, and then going on to lead your entire adult life in a psychotic haze, living on the streets, embarrassing yourself online and in public, etc. It'd probably be way easier to just keep things the way they are than have any realization of how wasted your life has been.