a) Has been on that cayenne pepper & water diet and is now so hungry that the photographer caught her mid-faint.
b) Is possessed, having sold her soul to the devil in order to be that thin.
c) Is going for that come hither look and failing miserably.
d) Is only 16 and is rolling her eyes while her mother gives her a lecture about her piercings.
e) all of the above.
The answer is b. No one is that thin without some assistance from the underworld. The god of evil, uncomfortable underwear, perhaps?