Cosmopolitan can safely be awarded the prize for yesterday's biggest social media botch-up, and it's a real Picard facepalm.

Cosmo's Twitter account shared a link to its inspirational story about 31-year-old Simone Harbinson and her triumph in the face of a life-threatening health scare. So far so good.

The angle that the tweet's author chose, though, was horrifying: instead of leading with details of Harbinson's achievements or highlights from her story, the tweet hooked readers by focusing on her weight loss and how she achieved it ("without *ANY* exercise"!) A byline read: "Despite several life-threatening setbacks, she's happier than ever at her healthiest weight yet."

As Bitch Media put it, "Cosmopolitan revealed that the secret to one woman's weight loss was...cancer. Yes, really."

Twitter quickly took Cosmopolitan to task, and the publication was rightly accused of romanticizing a serious illness and framing a 44-pound weight loss, caused by disease, as aspirational. In a cultural landscape where women are already exhorted to pursue weight loss at all costs from a terrifyingly young age, it's barely worth rehashing why this is so objectionable.

What is worth exploring, however, is the fact that it's not especially unusual for serious illness to be hailed as an aspirational weight loss tool, especially for women. In the comments to Bitch Media's aforementioned post, women are pouring forth to share stories about compliments they received about weight loss that occurred as a result of diseases and serious illnesses they faced (or are still facing).

For example, Lauren commented, "I am a three-time cancer survivor and I went to a conference for young adult cancer survivors in 2014. They had an "anything goes" discussion related to things like body image, sex, relationships, etc, and in the women's group, the one thing almost all of us had in common was that we lost significant amounts of weight during treatment, and that people in our lives told us how "great" we looked, or that it was at least a silver lining to our situation."

She continued, "One woman that I'll always remember's fuckin' oncologist told her at her diagnosis meeting that at least she'd "lose her baby weight." I'm just glad I had great doctors, and that all of the people in my life were friends and family, and not, you know, medical professionals. I am 1000 percent not surprised by this tweet."

Like Lauren, I was appalled but not especially surprised to read Cosmopolitan's tweet. In my experience, women are routinely complimented on unhealthy weight loss and explicitly encouraged to view weight loss as a "silver lining" of serious illness.

I remember, for example, sitting with my cousin and a mutual friend of ours in high school, after my cousin had returned from a two-week absence due to glandular fever. When she revealed that she'd lost 8kg because of the illness, our friend replied, with serious, pleading eyes, "how can I get it?" News swept through the school quickly, and soon dozens of teen girls were actively trying to contract glandular fever.

Or, consider a young woman I spoke to during my time at university, who resided in-house at a treatment center for her eating disorder (anorexia nervosa, to be specific). During a medical examination to determine the extent of her illness, a nurse – remember, this is while examining her for health issues related to anorexia – commented that she had "such a lovely, flat stomach."

In the wake of the controversy surrounding Cosmopolitan's tweet, I asked people in my social media networks if they had similar stories. Kelsey, 29, said that "during my time on Prozac – in the middle of the worst era of my mental health – I lost 30 pounds. Everyone telling me I looked great when I felt rotten inside was just [sarcastic *kissing fingers* sound]."

Holly, 24, said she got "Pleeeenty of "what's your secret" questions about my eating disorder, which was lovely" (the sarcasm abounds here), and Emily, 31, said "I had HG (hyperemesis gravidarum) while pregnant and was hospitalized. People told me it was good that I didn't gain too much weight and praised me for it."

Other comments included: "After an abusive relationship I lost weight because I stopped eating and sleeping and got shingles – people wouldn't stop telling me how good I looked" and "I got so many compliments when I was still undiagnosed with an autoimmune disease and losing weight so fast I stopped menstruating."

The responses continue to roll in and their sheer number suggests this is a real phenomenon and serious problem (see them here.)

Since this morning alone, I've heard from women (and a few men) who have suffered from chronic pain; cancer; depression, anxiety and PTSD; eating disorders of every kind; stomach bugs, flus and respiratory infections; broken bones and injured limbs; pulmonary embolisms and campylobacter infections – just to name some of the many serious, painful conditions – and all of them were complimented on the weight loss that resulted either directly from the illnesses or from the resulting stress.

It is – to put it plainly – supremely fucked up.

Men often dismiss female preoccupation with diet and appearance as a kind of "bitches be crazy" vapidity, but anyone for whom that's an immediate response isn't thinking hard enough about the problems at play here.

There's a reason women pursue and fetishize weight loss, even at such extreme costs: society consistently tells women and girls that the worst possible thing they can be is fat and/or unattractive. Messages about the undesirability of fat women saturate our social media feeds, comments sections and advertisements. Increased body size is correlated with decreased income for women in a way that it isn't for men. The real-world costs of being a woman society doesn't deem desirable are significant, so it's not surprising that women and girls deeply internalize these messages.

As Hannah put it, in response to Cosmopolitan's tweet, "Once again [this is] sending a message that the worst thing a woman can be is fat, even if it means you lose weight by life-threatening means."

While the body-positive movement is gaining significant traction and we're more knowledgable than ever about the harms of disordered eating and poor self-esteem, we shouldn't overstate how far we've come as a culture. Social media is still thriving with dangerous ideas about weight loss and body image, and real people – especially women and girls – are absorbing and regurgitating those messages, which often come courtesy of their friends, family and even medical professionals.

Women and girls are put under enormous (and gender-specific) pressure to look perfect at all costs, so the problem is a societal one that needs tackling on a social (as opposed to individual) level. That means holding publications accountable for their social media strategies and click-bait titles; it means challenging irresponsible medical professionals who tell their sick patients that unhealthy weight loss is attractive or a "bonus"; and it means speaking up to our friends and family when we hear them regurgitating these damaging messages.

All of us – including women and girls – should be valued for more than just how we look, and nobody should be encouraged to diet unhealthily or told that weight loss is a silver lining to serious illness. It's time to bring an end to this nonsense, and publications like Cosmo should be the first to fall in line.

Now read about the rise of the body-positive movement in fashion and how it went from fringe to mainstream.

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