I have struggled with weight issues my entire life. Two and a half years ago, I joined Jenny Craig to give complete control to other people. If it did not work, I was destined for some type of weight loss surgery. At 5'3", I was 264 pounds and developing signs of diabetes and sleep apnea, and already had muscle and back issues.
I followed the plan, made my own adjustments so it wasn't difficult to live with, and lost 119 pounds in close to a year. I have kept it for for two and a half years. I recommend it to anyone. It really is easy and you do not have to eat health food forever. JC weans you off of their food, shows you how to factor in dining out (I ate french fries every weekend beginning at Week 5), and works with you on how to maintain your new weight.
You mentioned that you tried JC before. How long ago was that? I really suggest you go back and try it again. Surgery is so invasive and does not get to the root of the problem, in my opinion. The JC program is based on the proper food groups you need to eat everyday to remain healthy (and lose weight). They also work with you to understand why you are eating the way you do and help you break through bad habits. Many insurance companies even offer a discount.
JC saved my life and I know it could help you. While I realize that everyone is different, I would recommend looking into this option and sticking with it for a period of time before going the surgery route. You honestly have nothing to lose...other than the weight.