Rob Kardashian is currently in seclusion after being rushed to the hospital for stomach problems days after Christmas
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During a family trip to St. Barths in August – which Rob, 28, did not attend – Kim, 35, joked about how her brother’s body art had changed over the years while discussing tattoos with Kris Jenner, Kylie Jenner and her boyfriend Tyga.

Kim quipped about how Rob covered his tattoo of his ex-girlfriend Adrienne Bailon‘s name with a tattoo of Rita Ora, who is now also an ex.

“He covered it with a life-sized Barbie doll of Rita that has now turned into a Cabbage Patch doll,” Kim said with a laugh of how the ink distorted after Rob gained weight.

VIDEO: ‘I Can’t Win Life for Him’ Says Khlo about Her Reclusive Brother Rob Kardashian

Despite the jab, Kim has been supportive of her brother throughout his struggles, posting social media messages about how they were working out together over the summer.

The episode came at a particularly difficult time for reclusive Rob, who has remained out of the spotlight and away from the KUWTK cameras for two years while battling depression and gaining more than 100 lbs.

Most recently, Rob was rushed to the hospital after Christmas for stomach problems, with some reports citing his diagnosis as diabetes.

“He has to take medicine now to control his blood sugar level,” a source told PEOPLE. “He was also told he needs to rethink his whole lifestyle. He needs to see a dietician and change the way he eats. If he doesn’t change his lifestyle, he was told that it could have serious consequences.”

Another source said he is still shutting everyone out.

“Rob acts like he wants nothing to do with the world,” the source said. “He doesn’t respond to texts from people that are genuinely concerned and checking up on him.”

The source added that Rob is back living with sister Khloé Kardashian and though he continues to be reclusive, once the holidays come to a close, the family plans on figuring out how to handle the situation.

“The family will come up with a new plan when the holiday is over and everyone is back in L.A.,” the source said. “They are of course very concerned about Rob and have been for a long time.”