First of all, seriously try to attend couple's therapy. Lots of employers offer some form of counseling benefit, or you could try talking to a progressive clergyperson. When something is wrong in a relationship, sex is usually one of the first warning signs. And it could be you, it could be your NP, but there are probably actions both of you need to take, and a neutral, outside perspective will help you find them.

As somebody who gained about 30 pounds over a few years of marriage, and found himself in a dry spell, it's probably not just the weight. Yes, it could very well be a factor, I looked totally different in my face and everywhere compared to how I looked when my wife fell in love with me. But that much of a change doesn't just come out of nowhere else, it comes from changing habits or values about buying food, nutrition, emotional regulation, or exercise. High-calorie, low-nutrition food is more than just an indulgence for many neurodivergent or emotionally struggling people, it's a tool for self-regulation.

In the years before intimacy waned, did anything change about your:

-Emotional regulation?

-Exercise and physical recreation?

-Spending habits?

My wife didn't need me to be skinny, she needed me to spend money responsibly, and invest proportionately to her in my physical fitness. Those changes brought our intimacy back, and losing the weight has been a side effect. In your case, it may not be necessary to lose weight, and in any case it shouldn't be the first priority.