Another possibility is that he is not one of those individuals who can embrace his hedonistic lifestyle without getting severe and acute effects. He might be having any number of serious problems such as diabetes, gout (allegedly), atherosclerosis and other vascular, cardiac and pulmonary disease, and you name it.
Recent pictures of him look like he has suddenly become obese, but if that is from edema, his liver might be shot.
Perhaps, but unlike us little people, he has no shortage of “voluntary” organ donors.