Though in my 50s, I was in a similar position to yours four years ago. I had always had a weight problem, but it got to the point where I was 100 lbs. overweight and uncomfortable physically, psychologically and emotionally. My feelings about my good marriage, successful career and wonderful son were "outweighed" by my insecurity and displeasure about my appearance. After doing a significant amount of research, I had lapband surgery -- despite fears of anesthesia and recovery, whether it/I would be successful, and, if so, whether I'd gain the weight back after I lost it. It hasn't been easy, but I'm down 85 lbs. (I lost 45 lbs. the first year, and an average of 10 lbs. each of the following three years), and getting the lapband is one of the best decisions I've ever made. It's a tool, not a solution, but it has helped me slowly and safely go from a size 20 to a size 12. I'm no longer embarrassed about my appearance, and I got over my fear of anesthesia to have a well-deserved tummy tuck and brachioplasty to remove the excess skin resulting from my weight loss. If you're stuck and really feel you need the kind of help that willpower, Weight Watchers, exercise and therapy haven't provided, read the stories on this site; I think you'll find them useful and inspiring. Good luck!