I'd get him a vet appointment with a fecal check (make sure to bring a fresh one with you and drop off at least more after to make sure no parasites were missed), along with trying out colorful bugs that are healthier than hornworms, like red runner roaches and green banana roaches. Hornworms aren't good as a staple, just as a hydration boost and treat. Could you post a full pic of entire enclosure, please? Also, what do you gutload with? Where in Utah do you live? We can try top help you find a reputable chameleon vet! Here's two charts for gutloading and types of feeder bugs if you haven't seen them already: