[MikeB]

At 233lbs you'll have to gain a ton of weight for them to approve a gastric bypass, that would seem very counter productive...
You are not far from where you truly need to be. Step 1 is just start walking and start tracking your calories being input. Simple things like stop eating white flour (replace with whole wheat/whole grain), drinking soda or other drinks with a ton of sugar. Eat protein with every meal (most people don't eat nearly enough). I started walking on a treadmill last Oct, I now run on my treadmill. It will take time but your body will adapt every day and get stronger. Once you get into a pattern of exercise it will only get EASIER!!! Please for your children's sake STOP SMOKING, even though you think you're being careful they're ingesting harmful side effects. If anything think about the fact that every time you smoke you may be killing your kids slowly...