You have a BMI of 72.4. (A BMI of 40 and above qualifies as MORBID obesity). For your own health (heart disease,diabetes,joint and back destruction ) - you MUST lose a lot of weight. Unfortunately, I have never seen anyone losing 290 pounds without a surgical procedure.
AFTER your weight had stabilized hopefully below a BMI of 30, you will have a lot of loose skin. You will not "need" plastic surgery for it and no insurance company will pay for anything with POSSIBLE exception for removal of the tummy overhang, but you will benefit from and have to pay for such surgery out of pocket.
I hope this was helpful.
Peter A Aldea, MD, FACS