Ok, IMO your caloric intake is still on the high side. My concern is your current blood pressure problems and the PE and IVC not allowing your to fully take advantage of mediations such as Meridia. But I would strongly suggest discussing this medication with your main primary physician to see if you could take it without adverse side effects. Meridia.

I would also suggest discussing the use of Xenical if Meridia is not possible.

I feel that you most certainly have tried hard to overcome your weight problem on your own without medications to assist you. Perhaps now is the time to go with diet and medication programs. These do work but take some time to fully accomplish your desired weight.

I hate to use the word obesity as I do not feel that you fully fit that category. But there are also many support groups that if you were able to get on the right medication for weight loss and have a nutritionist assist you then you would be able to obtain your ultimate results. Although this site refers to obesity it is an excellent site for assistance for those in your current state to have both medical and one on one support while trying to lose weight. The group name is: Obesityhelp.org Here you will find both medical and support that can help you obtain your desired goal of weight loss. You need to join and get in and start talking with others in your same position to see what has worked for them and how it may apply to you.

Some types of weight problems are related to Psychological situations in life. Thus my question on depression. Here is a link to further discuss this. This is not to say that this is your problem though just an avenue to consider.

So, to sum things up I would suggest still a slightly lower intake of calories. 1500 to 2000. Watch your water intake as not to retain too much.

Go to your doctor and fully discuss your overall concerns about your weight and the problems your having and question him/her in regards to going on specific meds to assist along with diet and supervised nutrition plans. This I believe is going to be the key to your success in losing and staying down in weight.

I would by no means recommend a gastric by pass under your current health conditions. This procedure would cause more adverse effects then you need.

I am including though for your information a blog on surgical procedures that you can become aware of.

I am also including a link for the AOA for your assistance.

I believe with the right diets given to you by a qualified nutritionist and medications approved by your doctor that will not contradict your health conditions or current medications you can do this. As I mentioned earlier you need a support person or group and I have provided links for this also. You can not do this alone or by yourself.

And also you mentioned that you felt disappointment in yourself. DO NOT LET THIS HAPPEN. Your able to do this. But sometimes it can not be done just by a diet alone.

I urge you to go to the links and make contact both with your doctor on the meds and the support groups. I truly believe that if you go this route that you will find the proper and needed weight that you are seeking.

If I can further assist you on this please do not hesitate to reply as I can and will be glad to continue to assist you.

But find a good nutritionist and go to your doctor to see about the validity of the meds mentioned above.

I wish you all the best and do feel that once on a program that you will be able to do it.