When Marisa Zeppieri-Caruana had a lupus flare-up a couple of years ago, it brought on severe weight loss, a small stroke, heart problems — and a shower of compliments.
"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."
A petite 5'3", Zeppieri-Caruana plummeted from 108 pounds to 88 pounds in a matter of months. But despite the hospital visits, the constant medications and eventually, the wheelchair, many people assumed she'd purposefully dieted and exercised to achieve her emaciated look.
"I'm a big juicer and my friends all thought it was some new juice diet," says Zeppieri-Caruana, who ate Outback wings and fries every night in a desperate attempt to gain back weight. "I'd try to tell them the severity of the situation but it was like the skinnier I got, the more I heard about how great I looked. Men, in particular, thought my body looked fabulous. I'm like, 'Wow, that's really sick. I have to be anorexic to make you think I'm attractive.'"
According to Stephen Franzoi, professor of psychology at Marquette University in Milwaukee, when someone focuses solely on weight loss instead of the illness that brought it about, it could mean they're uncomfortable with disease.
"Illness can be threatening to other people because it makes them aware of their own mortality," he says. "It makes them uncomfortable. So they'll blurt out something which in another context would be a compliment."
That's just one scenario, though.
More from TODAY.com
This 4-year-old's love letter to school crush is the cutest thing ever
What lady wouldn’t be won over with compliments and promises of fine dining and magic tricks?
- Traveling for Thanksgiving? Leave now.
- 16 adorable 'Movember' babies show off their 'staches
- Take 30 seconds and watch this teddy bear dog run on a treadmill
- Duchess Kate launches fundraiser for new children's hospice facility
- This 4-year-old's love letter to school crush is the cutest thing ever
People who fixate on weight loss instead of the larger picture — such as a friend dealing with constant nausea and vomiting thanks to chemo — are lacking social sensitivity, he says. They're also, well, clueless.
"I think the people most likely to make these kinds of comments are the ones who place a lot of emphasis on physical attractiveness and appearance rather than personality or physical health," he says. "They may well be oblivious to the emotional impact and harm they're causing people, simply because they don't place much attention on the inner self. The outer shell is the only thing that's really important to them."
What can people battling disease do when those around them focus on the frivolous?
Lose a bit more baggage, says Zeppieri-Caruana.
"Those consumed with looks and being 'perfect' have distorted points of view and I've learned that I don't need those people around me," she says. "Life is tough enough."
© 2013 NBCNews.com Reprints