Bloodwork back, good and bad news

Cholesterol in your blood has pretty much nothing to do with the cholesterol you eat. You need a healthier diet overall and better exercise habits if you want to fix cholesterol. Basically cholesterol is essential for your body. When you don't eat it your body makes it. And unless you stuff yourself with eggs and butter and crap all the time your body makes most of the cholesterol inside you. What you eat accounts for very little. So the reason your body is making bad cholesterol? Crappy overall diet consisting mainly of processed foods, lack of exercise and possibly a smoking habit. You need to eat more fresh greens and fruits and lean meats and stay away from the junk food and trans fats. There's nothing wrong with a little but your blood work says you have been overdoing it.

Your cholesterol numbers will improve as you lose weight. It's probably the greatest factor (outside of genetics).
That said, as the poster above states, get more soluble fibre in your diet and cut some carbs.

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Keep the saturated fats down, nix the trans fats altogether.
I had high cholesterol prior to starting this journey and was on the verge of being put on medication to help regulate. After losing 30 pounds and dropping into the "overweight" category of my BMI, my blood cholesterol levels had dropped substantially into the "normal" zone.

Just keep doing what you're doing, it will improve.

I have always had a high / borderline high total cholesterol level, but have been lucky enough to have a kick-*kitten* HDL-LDL ratio such that even with a total number around 240, my docs have always said more or less "you're in good shape." When I lost a bunch of weight (about 50 lbs, say) and reintroduced regular physical activity, my total numbers crept down a little bit (still above 200), but the HDL-LDL got even better. Last blood work had my doc say "Jesus, just keep doing whatever you're doing." Made me smile.

Focus on losing your extra weight and getting some regular exercise you can stick with, and check again in December as your doctor suggested. Weight and exercise are the things in your control and they can have real, meaningful effects. Yes, there is a genetic factor, but focus on controlling what you can control.

Good fats: Mono and polyunsaturated fats. I.e. olive oil, canola oil, avocados, olives, nuts, seeds, peanut butter, flax and chia seeds, fatty fish, soy milk, tofu. Oatmeal is also great for lowering cholesterol.

Bad fats: Trans and saturated fats. I.e. beef, lamb, pork, chicken with skin, whole-fat dairy products, butter, cheese, ice cream, palm oil, lard, pastries, cookies, muffins, cake, pizza dough, packaged snacks, stick margarine, vegetable shortening, fried foods, candy bars.