Realistically dealing with cholesterol levels is a hard thing in general.  They have medications of course.  But the reality is that they don’t always work.  For example, one girl I’m closely affiliated with has a family history of obesity in general.  But she also has extremely high and rather dangerous cholesterol levels at the age of 30.  She has taken every medication, actually eaten a lot of the supposedly good foods with antioxidants that can lower bad cholesterol levels, worked with good fats to raise good cholesterol levels to balance it out, she has been ridiculously dedicated.  I on the other hand have never had a single problem except low cholesterol.  But we’ve both had exceptionally hard times trying to control things in general and make them different.  It’s not unusual by any means.  I mean these methods are proven in clinical studies, but they don’t always produce the amazing or beneficial results you would like to see in general.  So yes, definitely diet and exercise, there’s no excuse not to.  Definitely eat the right foods and use the right meds if it is that bad to try to deal with it.  But at some point, you have to just hope for the best.