Well - Really Diet and Exercise. I went to a couple of those seminars about the gastric bypass and it scared the crap out of me. And my insurance company would not pay for it. So ... I have a friend that lost 220 lbs. She was 377. She is over 40. She is doing watch watchers. I didn't want to WW because I don't think it would work for me. She said to me "when you are ready you will lose the weight" I thought to myself "I am ready." So at first I just cut out the crap and eating out. That was a couple of weeks. Then I added the exercise bike. Then I replaced all the high caloric foods we loved with sugar free or low sugar. Typically we have light and fit yoguart 45 cal, cheese sticks 80 cal, Sugar Free pudding 60 cal, Quaker bars 110-120 cal, and water. Also prepackaged lunch chips 130-140 cal bags. Pita instead of bread. Broccoli 3 cups a week. Lots of Salad and Boneless/Skinless Chicken, tuna, and super lean taco meat.
That is it in a nut shell.