I'm the same general area as the OP. Here is my details - buried pretty deep in this thread so maybe not quite so embarrassing.
68" and 345lb as of this AM.
I need to lose 150 lbs to begin to be healthy.
For your reference, Its a 3xl button down shirt (20"+ neck with long arms), Most t-shirts you can buy in the store don't fit. I'm a 3x easily. 48" waist and 30" inseam. Walmart is essentially the only place I can buy any clothes, and I'm at the top tier. They don't sell any 50" pants except dickies, and those aren't quite pants. They had 2 belts in the whole store that would fit, I bought them both. 1 has broken.
I go through shoes in less than 2 months. They just wear out the poor things.
What I've done:
1. quitting smoking dec 2009, I was 290ish then. Within 2 weeks I was over 300 and within 2 months I was over 325. I knew it would happen. I felt strongly that ending smoking was more important than "a few pounds". After all I figured once I quit I'd have all this energy to exercise. Well now my lungs are clear but I still can't exercise for shit.
2. No soda whatsoever. No empty carbs, no sugar, no candy, no ice cream. In fact this has been a rule for nigh on 3 years now. Tea, Coffee, Water and a sugar free energy drink are all I really drink. Occasionally I get a diet soda, but I hate the farts they bring so...
3. Have a bike, found out I can't keep up with my friend (who is actually heavier than me, just he's built up a lot more muscle. Wife and I ride occasionally (like every 2 weeks maybe 2-4 miles at the park.
4. Too heavy for wii fit though I'll come along on the long run with my wife maybe every couple weeks when she brings it out.
I know perfectly well that I fail at portion size. I don't think what we eat is terrible, its lowish carb, hi-protein lean chicken and some beef and tofu, lots of raw and cooked vegetables, and we've been on 3 meals a day for a couple years now - once we realized that 1 meal a day was horrifying.
So I know I'm eating too much still (even if its "healthier" - 1000 calories of broccoli is still 1000 calories )
I also know I'm not active enough. I'm honestly a little fearful for my heart, every time I do aerobic stuff I'm puffing air like mad and while it doesn't hurt the feeling of palpitations as my poor heart beats like mad is just distressing.
So really - any serious options? I know I need to get serious about mealtime and I know I need to get serious about moving my ass some.