You have no idea if he's out of shape or not if you're basing on just pictures and clothed at that. Weight and height are not 100% accurate, but 200 lbs. under 6 feet without a ripped body or some demonstrated physical prowess is out of shape.
He was exercising with MMA 3 times a week.
I understood the PA to say it was after the incident.
It was when he told her he couldn't sleep during his 2011 establish appointment.
This whole topic is irrelevant.