Married But Not Dead

I’m lost folks, please help. I’m in my 40’s and my wife is in her thirties. We met 20yrs ago. I’m within 5lbs the same weight when we met. She has literally doubled in weight and weighs more than I do now. I’m not exactly slim and buff but I’m not rotund either. The problem is I am no longer attracted to her at all. But I love her more than anything in this universe. And to top it off she hasn’t wanted or been remotely interested in sex or even just oral for me for a long time. And by long time I mean almost 3 years now. We are completely loyal to each other. She has zero desire to work out or eat healthy. What do I do?

UPDATE/Added Info Met when she was 20 and I was 27 No kids She does have some medical issues that contribute but not all of weight gain There are factors to weight loss but that doesn’t change the fact that it needs remedied I do tons of stuff for her and our marriage including date nights and other fun events centered around appreciating her and making her feel special and loved Ozempic and other weight loss types are too expensive and insurance won’t cover… we’ve tried not an option