“I was a walking skeleton and eventually wound up in a wheelchair,” says the 33-year-old freelance writer/editor from Fort Lauderdale, Fla. “But the crazy thing was people thought I looked great because I was so thin. They’d ask if I was working out and I didn’t have one muscle. You could see every bone protruding out of my shoulders, my elbows, my wrists.”

Zeppieri-Caruana is hardly alone when it comes to receiving covetous compliments in lieu of a sympathy card. People suffering from broken jaws, gastrointestinal woes — even cancer — have all had friends and strangers alike brush off their suffering in order to rejoice in their “fabulous” weight loss.

“In college, I got a severe case of mononucleosis and lost 30 pounds over the course of six weeks,” says Jessie King, a 24-year-old web designer from Minneapolis. “And everyone said I looked great. My friends would be like, ‘Are you still contagious? Do you think I could still get it?’ They wanted to get it so they could lose weight.”