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I think it's HGH gut. Man's rich as hell, so of course he's going to pay for all the health and life-extending stuff he can get his hands on. Human growth hormone can combat aging, but it's not perfect.
His capacity for retaining and spewing shit has been exponentially growing as well. Coincidence?
One way or another: he's full of it.
Aka Rogan Gut
Here I thought it was a colostomy bag
https://www.snopes.com/fact-check/elon-musk-photo-chest-stomach/