Certain facts... your BMI is about 38.. that makes you morbidly obese.
You have PCOS.. a metabolic problem linked to obesity.
Strong family history of lifestyle diseases.
With this profile the standard of care is to plan a bariatric surgery.... for permanent and sustained weight loss.
Non surgical options like diet control or intragastric balloon are likely to fail in the long term.
It requires extensive counselling for you to decide what is best for you.. . And understand all the risks and benefits.
Do your research... look for surgeons with good reviews and ask them to introduce you to some real people who have undergone the procedure.
A program with an active obesity support group is likely a good one.
Next Steps
Talk to a experienced weight loss surgeon, and ask him to introduce you to some of his patients. Best of luck