Anna desperately needs a friend to tell her to stop doing this shit to herself.
Anybody who tries having a come-to-Jesus talk with Anna about anything—especially her weight, her eating habits, and her dishonesty—is seen as attacking her. She then declares them toxic, haters, bullies, judgmental, demanding, etc.
We've seen how she's always responded to even gentle criticism from her followers, or mild correction on factual points—by either getting defensive and bitchy and telling the commenter that they don't know anything, or just straight-up blocking them.
She can't take any criticism at all. Even for a Narcissist, she's really bad at it. Successful Narcissists don't like criticism either, but they can and will use it as a guide to how they are failing to convince others that they are who they claim to be, and strategically alter their behavior and self-presentation accordingly.
But Anna doesn't; she just doubles and triples down on whatever she's been doing, even when those efforts further prove how delusional she is. Her insistence that she has no more burnable fat on her body because it's all lipedema, and that she's fat because she has two rare genes (that are so rare nobody's even studied them) are typical. So is calling a couple of mildly critical comments on her podcast an "avalanche of hate" (or something like that.
So I have no doubt that plenty of friends and family members have tried speaking truth and reason to Anna—and that's why Anna's friends keep disappearing, and she continues to have such a strained relationship with her family. She simply cannot tolerate hearing that she is in any way at fault for anything that is wrong in her life, and will push people away for pointing it out. And I suspect Tracey is still in the picture after so many years because she's either decided to practice radical acceptance of Anna's insanity, or has had so many exhortations to "keep sweet" ground into her that she's incapable of calling out bullshit.