Step 1: Know Thyself

And to thy own self be true, yes? How would we ever start on a fitness journey without knowing from where we come? So, start here. THEN, we'll talk goal setting.
If you haven't seen your doctor in a year, it's time to plan a visit. Take a fasting blood test and ask your doctor to supply you with your stats. Then, ask him how your numbers appear to him. Here are the really important ones:
-fasting blood sugar
-cholesterol
-triglycerides
-blood pressure
-thyroid
For any of these numbers, there are solutions. Most problems are solved through diet and exercise, HOWEVER, if your doctor sees that you need medication for your problem, take his advice into consideration. After all, heart disease and diabetes are major killers in the United States. You may have to go on medicine for a while, but you may be allowed to go off later if you get it under control using diet and exercise.
Another topic to really discuss is the thyroid issue. Men have thyroid problems, but women are far more likely to have a problem after having a child or changing hormones in some part of life. Many doctors may try to convince you that your thyroid numbers are fine because there is a very large range of "normal." "Normal" may not be your normal, so if you experience any of the following, you must tell your doctor while going over your thyroid number:
-lethargy
-fatigue
-excessive weight change
-hair loss
If he or she is not listening to you, seek the advice of another doctor. Thyroid issues are serious, but unfortunately, they are largely ignored because the symptoms appear so vague.
Also, if you feel normal, hold on to your thyroid number. This way, if you do have a life change, you can revisit that number to see if it has indeed changed.
Once you have gotten your medical advice, and your ok from the doctor we can move on to step 2: goal setting
See you soon.