Not to turn this into a thread about Patrick, but it sounds to me like he's having major health problems that are not being properly addressed. A 27 year old man with ED who has gained 100 lbs in the past YEAR is far from undiagnosable, regardless of numbers. I've had friends with not totally dissimilar health problems related to endocrine dysfunction who were able to finally get help from an ACAM
physician. If he hasn't had a second opinion, or even if he has, I recommend looking on their website to find a doctor near you who may have a different outlook on things. I myself began suffering from some adrenal fatigue and other problems which were solved by Dr. Mora in the Sacramento area. Don't accept "there's nothing we can do" as an answer for problems like this. /tangent.
Interesting that intimacy has been distasteful for a long time. Agreed that there may need to be some redefining of relationships - I hope that's something he can handle, but from the sound of things, he's a very kind and understanding person. Best of luck to the three of you.