You can't save her. You can't help her, even, until she decides she's worth helping.
I'm sorry to be so harsh about it, but the reality is that sh'e showing a lot of self-destructive behaviour and clearly has some very deep-rooted issues. This is not something you can fix by being nice to her or paying her compliments and it won't go away if she loses weight, has cosmetic surgery or becomes more popular than her sister. It has very little to do with her sister or her weight or anything else, except that these are justifications for the fact that she doesn't value her own life.
This is not a case for laymen. She needs professional help; unfortunately, until she decides that she's worth helping that's not going to happen. In the meantime, the absolute best you can do is continue to be her friend and try not to get too worked up about it. The bottom line is that her path is laid out for her now and that only she can change it; if you let yourself get dragged down by the fact that she continues her destructive behaviour, all you're doing is harming yourself and not helping her.
So basically you just have to accept her for what she is. I know that's not easy, because you don't want to see your friend doing this to herself, but there's really no other option for you here. If and when she wants your help, she'll come to you.
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I wake up in the morning more tired than before I slept
I get through cryin' and I'm sadder than before I wept
I get through thinkin' now, and the thoughts have left my head
I get through speakin' and I can't remember, not a word that I said
- Ben Harper, Show Me A Little Shame
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