Call your insurance company first and ask if they cover weight loss surgery at all and if so what are the requirement (co-morbidities, 6 months supervised weight loss, etc) some companies have an exclusion and will not pay under any circumstances, some are easy and simply require a letter from your doc stating this is in your best interest. After that, if covered or you are willing to self pay make an appointment with your PCP. Prior to that sit down and write a list of all the diets and exercise programs you've tried and a list of all the physical and mental/emotional problems you have because of your weight (the obvious like high blood pressure or diabetes, and the not so obvious like back or knee pain, fatigue, depression, etc). The more ammo you have, the better!!! Also, shop for a surgeon. I went with the one who is 'supposed to be the best in the area' and he and I just don't mesh, wish I'd chosen someone else, particularly now that i have had major problems.
Best of luck as ou begin your journey!!!!