No idea where to start

So, I am brand new here. I am really thinking about bypass surgery. I've dieted, walked, and im currently on metformin to loose weight (it's not working) my bmi is 42, I have staywell insurance. I don't really know what to do to get started. Im at a loss. Help?

Orlando is a major metro area and you have a LOT of options.  Research the bariatric surgeons in your area.  Most of them offer free seminars to anyone that is interested.  That will give you an overview of the different procedures as well as an overview of the surgeon's practices.  Usually some of the office staff are at the seminars and you can have the opportunity to meet them.

First thing I would do is talk to your primary doctor and see if they are on board to give you a referral.  Insurance often requires months of supervised weight-loss visits, so get those started.  It is as simple as going to monthly visits with your primary to have her document your weight loss.  

The surgical practices are usually familiar with the various insurance processes and can help you with the guidelines.  Sometimes you do have to find out for yourself what kind of coverage is offered, so give your insurance a call to find out if your plan even covers the surgery and what the conditions are.

Ty for your help. Its all so overwhelming. Do I also need to see a nutritionist? Ive heard I do, but im in nursing school....wonder if I can show I've taken the class lol. 

I feel I should know more about how to get this rolling, I'd hate to be denied.

Research is so important!

Go to surgeons' informational seminars. Watch for a practice that offers solid follow up support - support groups, dietitian on staff, etc. Most of all - go with a surgeon you TRUST IMPLICITLY and who specializes in bariatrics. Many docs don't have the full depth of knowledge needed to deal with bariatric needs. 

Your insurance will guide all the other pre op steps and requirements. Some may go hand in hand with your doctor's requirements, but some may be additional. I had to document 6 months of participation in a medically supervised weight loss program, a psychological evaluation, a cardiac eval with stress test, documentation of weight history from my primary care doc along with a referral, etc. 

I did a lot of reading prior to surgery. I wanted to be as informed as possible and read books about post op life and maintenance strategies. 

Get started with a support group as early as you can. You will hear a lot - take notes! - and you will meet people who can offer phenomenal support and advice. I am still friends with many who had their surgery a year or so ahead of me...

Best wishes!

I am in the beginning stages of getting bypass surgery, I am going with Dr. Keith Kim.  He seems great so far.  They have information sessions that you can attend free every month.