she won't be able to lose any weight until she conquers whatever it is that makes her want to binge. no amount of exercise, dieting, or surgery is going to get her to a healthy weight because mentally, she is too weak to stay on task. she needs to get a psychiatrist to help her overcome her trauma or else she is going to die like this.
imo the first step she needs to take is to get off the damn internet and actually get some fucking help! if she wasn't so damn busy trying to build a lifestyle off of her reputation of being an obese trainwreck, she could have taken this first step already and gotten the help she obviously needs-