Wow, that's a real big boy! He's gorgeous!
I don't think he looks obese, but does look good and chunky. I'm hesitant to say you SHOULD switch to medium rats.. but doing so may get him to lose a little weight. For frequency, I'm not sure when adults start to slow down on their meals. My three year old boy eats small rats weekly and hasn't refused one yet. From what I've been seeing, it seems that you should judge how often to offer food by how the snake reacts. If he's taking meals weekly, then I see no reason you shouldn't offer weekly. If he starts refusing, then it may be time to cut back to every 10-14 days.