[asphaltgambler]

I know saying this is easy, but doing it is the hard part. Your wife has a come to Jesus meeting with him. Instead of scolding him, she should shame question him about his behavior. What do I mean by this? In a calm voice she asks why does he neglect his health? What drives you to not want to be healthy? Why would an intelligent, capable mature man not want to live normal, productive life?

This is how you deal with people, who for whatever reason, refuse to take care of themselves. Absolutely for sure, there is something in their past that is the driving force behind that. If you asked them point blank why, most if they were completely honest, could not put it into words themselves. If they are unwilling to discuss this crucial component driving their behavior, then it's on them and your wife can walk away in peace.