Excercise for breast reduction w/back issues

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Hello all! I'm so happy to be on here! I have a problem with my back, neck and shoulders and many have said it’s probably due to my breast size. I am getting on new insurance (through healthcare.gov) April 1 and looking forward to the possibility of a breast reduction in the coming year. The plan I chose is through Cigna Healthcare and a PPO so I did the research first and they do this as a medically necessary procedure. I think I need to lose weight beforehand although some people say I look fine and some say yes; lose weight. I KNOW I have to lose around the middle. My issue is trying to exercise now (which is difficult) along with a healthier eating style (which I am capable of doing). Also how do you lose this stubborn fat around the middle?? Any thoughts? Has anyone had this issue, been through this and/or what was your outcome. Thanks to everyone for any help!