One of my Rams looks very bloated and pine-coned a bit also. I imagine it is terminal, the so called 'dropsy'. I've had it before with a molly, but not a Ram.
Dropsy can occure with all species of fish. Can be caused bij several bacterial / viral infections and is sometimes treatable when early diagnosed and that's the problem. The pineconing-stage is often too late for that cause organs are dameged in an inreversable way (kidneys).
Rams are under suspecion of beinginfected with Iridovirus (just like Dwarf Gouramis). Dropsy can be a symptom of that as well (= untreatable).
I'd euthanize it (sorry) but maybe tehere are other opinions.