37 year old mother of four, married for twenty years.  Reason for requesting surgery is my worsening knee and back pain that is affecting my daily lifestyle.  i just want to get to a healthy weight and look good to continue the rest of my life with my family.  I have been overweight for the last eight years.  I noticed my weight went up 30-40 pounds in six months after i began to have autoimmune health issues.  I think this has been the cause of why i have such a hard time losing weight and keeping it off.   I was just talking about the issue that i never see myself asd fat until i am forces to see it in pictures of when i see people that i have not seen in a long time.  Then I become embarrased about what i have let happen to my body, this to me feels like i have failed in some portion of my life.  I want to set a good example for my four children and at this weight i am not showing hte confidence i have inside beause i just want ot blend into the walls and not be seen.