Losing weight is not that hard. It is simply a matter of putting less food into your body than you body is utilizing. Unfortunately some people want the results fast and that is when people resort to fad diets, pills and lap-band surgery.
Is surgery a realistic option? I have watched people keep the weight off with lap-band surgery and I have also seen them gain weight after a weight loss. You see the lap-band surgeon never explained to those patients that the stomach is very adaptable and will grow to accommodate more food over time. The same is true when patients have part of their stomach removed to make it smaller. If they don't learn to eat less then over time they will go back to where they started, obese again.