I had a bit of a wake up call when my GP suggested that it was something that I consider, so I spent a fair bit of time looking into it.

A little background info just for context:
I am the pixie's DH - She is an insurance lawyer that has spent a lot of time managing medical malpractice claims.
I've been large for a long time - I was 85kg when I was 16, and by my 20th birthday I was 175kg, at the time I was very active, played rugby at a semi-pro level and was definately the wrong person to meet running the other way. I'm much less active now, and I'm around 140kg at the moment.
I've also worked as chef and have an ongoing love affair with good food - I don't eat badly.

I'd been trying various things to lose weight - various supplements, Atkins, CSIRO, etc...none of them worked terribly well. I bought low fat foods, and drank diet sodas.

My conclusion after looking at the lap banding for a while was that it was not a step I was prepared to take, without making sure that I'd exhausted all the less-radical alternatives.

I'm now losing around 5kg a month - by cutting out all commercially processed foods (no low fat products), artificial sweeteners (so no more artificially sweetened diet foods) and reducing simple carbs as much as possible.

The principle we are working to is simple - the risks of obesity have increased massively in line with the changes in diet over the last 50-60 years, so we're trying to eat a diet that would have been available over 60 years ago.

This means that we tend now to only buy raw ingredients and work from there - we make our own jams, preserves, stocks, sauces and dressings from first principles - we've even been tinkering with curing our own meat and fish.

A big part of the diet is the concept of whole food - whether eating plant or animal, consume as much of the by-product as possible. If we buy carrots or beetroot, then they come with all the leaves, stalks, etc - cooking a chicken or joint of meat then implies making stocks and soups from the bones, pates and terrines from the offcuts.

The end result is that we are eating extremely well - we have people queuing up to have dinner with us - I'm losing weight, and the pixie has had the most amazing pregnancy - no sickness, cramps, sleepless nights, stretch marks - really could not have been better.

I'm also eating less, much less - I have a personal theory that one of the side effects of the modern diet is that the feedback mechanisms to control hunger are disrupted. Food is no longer an impulse thing, it takes time to gather the ingredients and prepare a meal. Most animals spend a huge proportion of their energy securing their food - it seemed to me that we had made it too easy and too far removed from a natural process.

As an example - I made fried chicken last week. From the point where I decided to make it, I had to wait for the weekend markets to get a nice whole chicken, herbs and buttermilk. The chicken was jointed, the breasts frozen, and a stock made from the carcass - the legs were marinaded in the buttermilk with herbs and spices for a couple of days. The chicken was dredged in wholemeal flour with more herbs and spices before being fried and then baked in the oven to render out the remaining fat - it was fabulous. The chicken was rich and creamy from the marinade, the coating was crisp and spicy - but it took me a week to make and when I finally got round to eating it I was barely able to finish the leg (one thigh, one drumstick) that was my portion.
It is not long ago that I would have quite happily have eaten the entire chicken without a second thought.

What's my point in telling you all this?

What I am doing is hard, it involves putting a lot of effort into thinking about what I eat and how I am going to prepare it - if you are reading this and thinking that the lap banding might be an easier solution then think again, from discussing the implications of the procedure with a lot of people I concluded that living with a lap band was going to be an awful lot of work and would require permanent changes to diet and lifestyle that I couldn't live with.

I'm not advocating that my approach will work for anyone else, or trying to put you off the lap banding procedure - but you do need to be really, really sure in yourself that you have done all that you can to change your diet before making this step.