Your first step should be to your insurance co. Check to see if they even cover WLS. If they do ask, what are your requirements? Most go by what you weigh currently. After you find out you can move forward. Most start with your GP. I started with my GYN. I see your BMI is 53... "most" insurance require a Min of 35 with two comorbidies or a 40+ with no co's. I was the 40+ with no co's. 5'2" SW: 232. 2009 i had the LB and was the perfect bandmember till 2017 when my band slipped due to a virus... Till then i had zero problems and maintain my WL at 143#.
As far as choosing a WLS, this is up to you and your WLSx.... He/she will help you make the best choice. There's a lot more than just bypass or sleeve. Gastric Sleeve, Vertical Sleeve Gastrectomy - (VSG), Lap Band (yes they still do them), Gastric Bypass -(GB, RNY), Mini gastric bypas (MGB), Duodenal Switch (DS), Stomach Intestinal pylorus sparing (SIPS), Gastric sleeve with plication, Band with plication, Balloon .... and i'm sure some i don't know about. At this time... the VSG is the "sweetheart" of the WLS world right now.
There are other things to consider when having WLS. The biggest one (i think) is what do you expect from WLS and what are you prepared to gain and lose from it.... Losses are always just weight. WLS community has a very high divorce rate. You sometimes lose family and friends too. You also have to be prepared for the questions on your health. When you start to lose where people notice, they will ask questions as to if your sick? how are you losing? ... you need to choose if you are going to tell anyone. If you do, don't expect those people to keep it a secret. At first, i only told my (now ex) husband, sons and a few very close friends.... Well that was just the amount for everyone to know... This time, VSG 8 months yesterday, only my now-husband knows. I didn't tell any family, friends or co-workers.
I also suggest you go watch some Dr. V youtube videos... he is great and always 100% spot on. He curses but gets the point across. He has so many.....
re: sleeve vs bypass, see what your surgeon recommends. There are some health conditions that make one surgery more appropriate than the other (depending on what health condition you're talking about). If you don't have any health issues that would warrant one surgery over the other, then you'll have to just decide which one you're more comfortable with - and which you think would be a better "fit" for you. They're both good surgeries and there are people who've had great success with both.
