Hysterically Looking 4 Help

I'm a 39 years woman and I have had 5 kids.  I've lost and gained height throughout the 21 years of my first born.  I'm now in the process of lossing weight again, but with or without weight gain I've always had a pouch.  I've lost as much as 50 pounds and gained just as much without avail of lossing my pouch.  I also have a back problem and just recently been diagnoised with chron's disease.  I've tried diets and trainers of all kinds.  My recently weight is 235 pounds but I'm striving to lose 45 pounds.  I'm very optimistic about my weight but is very hard to do when I also work nights.  I have gotten several consultations and they all say the same thing, I need to lose weight and the procedure cost over 10 thousand dollars.  I just don't have that type of money!  I do have insurance but is hmo.  What do you recommend on this dilemma?


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