Don't weigh enough for surgery?

my pcp feels that I do not weigh enough for wls. I am 5'4" tall and weigh 230. I am just about 100 lbs overweight and barely 40BMI with no serious co-morbities, only a bad back and four thousand failed diets behind me. My sister has diabetes. My pcp wants me to try a diet again, but I know in my heart this will not work. Any advice for me? I'm SO confused.

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