Much love to you, FS. I can't imagine how hard it must be trying to be the voice of reason and rationality in all of this.
My mother was not an A, but she was cripplingly co-dependent and that behavior demonstrated itself in many ways. She used food as her coping mechanism, and was extremely morbidly obese most of my life. She was unable to work the last 12 years of her life. She was largely housebound the last 3 years of her life. She was largely bedridden for the last year of her life. She had diabetes, high blood pressure, high cholesterol, severe depression, etc. etc. etc. We all tried to talk to her, multiple times, about possibly having weight loss surgery. For YEARS she insisted that WLS was not indicated for people with diabetes (which we all knew was horse crap because diabetes is a QUALIFIER for WLS, but she was no different from an A in this respect. She had convinced herself of certain things that allowed her to remain in her comfortable rut of food addiction and co-dependency).
Finally, in her last year (when frankly, it was likely too late), she suddenly latched onto the idea of WLS. Their insurance company declined to pay for it, and she refused to file any sort of appeal or protest. And in that moment, it became obvious that for a brief time, she was in the midst of that moment that you talk about--when the physical pain outweighs the emotional temporarily. But it took very little to derail that "commitment" to survival.
When my mother died in 2012, she was 5' 4" and weighed nearly 500 pounds. Although her health had been incredibly poor for years, it was a MRSA infection, which came on suddenly and quickly, that killed her. She delayed getting medical care, because she was mortified by the numerous times over the past few years when a team of six or more EMTs would have to come to the house to carry her out, because she was so heavy and virtually unable to walk.
I share that story because I think that this dysfunctional thinking appears all. the. time. in our culture. Sometimes it's on a smaller scale, and isn't as wholly disruptive to life in general as addiction is. But recovery has made it so much easier for me to deal with this kind of dysfunction, in all its manifestations, because it is truly everywhere. I'm eternally grateful that recovery helped propel me out of an abusive marriage. But I'm also very grateful that recovery just helps the way I engage with the world on a daily basis.