Starting out, should I start with macros?

Macros are mostly an issue of nutrition and health. If weight is your first concern, start with calories. Calories are key to weight management. For most people (without an unusual diagnosed condition that says otherwise), getting to a healthy body weight is the single biggest contributor to improved health.

This is a great general on-ramp to using MFP for weight loss:

http://community.myfitnesspal.com/en/discussion/1080242/a-guide-to-get-you-started-on-your-path-to-sexypants/p1

Don't be put off by the joke-y clickbait title, the info is solid and sensible.

Beyond that, this was my approach to eating, which I used through losing 50+ pounds, obese to healthy weight, and for maintaining a healthy weight for 5+ years since (after about 30 years of obesity previously):

http://community.myfitnesspal.com/en/discussion/10636388/free-customized-personal-weight-loss-eating-plan-not-spam-or-mlm/p1

You don't have to do everything all at once. Just take small, incremental steps in a positive direction, and keep taking them. Patience and consistency brings results, because the majority of our days determine the majority of our progress.

Wishing you much success!