I also managed to keep the appointment he arranged the following week with a nutritionist from the local hospital - and I was glad I did! She gave me tips and dietary advice I could RELATE to, and (since the number of chins I had in recent photos told their own story) actually wanted to take - reducing portions, dropping the white refined starches and sugars where possible, and adding more actual fruits and vegetables to my diet, while keeping the meat (but choosing leaner cuts).
So, armed with this knowledge, I began my walk (literally, since that's been my most frequent exercise) back toward health, and back toward being able to face myself in the mirror.
After a month or so, I was punching new holes in my belts.
After two months, people were recognizing the changes in my face and my physique.
At three months, when I went back to my doctor, he gave me the rundown of what my efforts had given me (noticeably lower blood pressure, blood sugar, and cholesterol), and what they had cost me (29 pounds, with around 10 more lost since then - I was already back under 200 pounds and didn't realize it, since I still rarely weigh myself!)
I haven't cried at each of these little milestones, but I've wanted to... not out of pain, or mourning (although other family members' past struggles were clearly on my mind throughout), but rather crying from joy, and from the satisfaction that I lost weight that I seriously needed to lose for the maintenance of my good health, and used no surgery, gimmick products or activities to achieve that goal.