I hate to say it but it looks too real and grotesque to be fake. I wonder if fats at that stage are deranged enough to still say shit like "delightfully thick," "more to love" or "a few extra pounds" about themselves. I mean, at some point, the crippling depression and sheer feeling of misery has to be so overpowering that it can circumvent the default self-delusion or... fuck, I don't know, something.