My first reaction was, "take her home and feed her, and maybe she'll recover." And then, "maybe I can be an organ donor and give her 10-20 pounds." The photo reminded me a lot of the pictures on the old Anorexic Rec Room (anorexia fetishists) site.
I thought she looked disgusting. But then I thought about the fact that if it was me up there in a bikini, a lot of peole would think that I looked disgusting too.
And then I thought about fat activists, and how they would scream bloody murder about people telling me that I look disgusting. And yet, many of these size acceptance activists would have the same reaction that I did to the picture-- eeewwwww! Why is it OK for me to have that reaction about her, but not for people to have that reaction about me?
On the other hand, I think that it's a truly fucked up society that tells us that being thin to the point of being unhealthy (as she certainly looks in that photo) is the ideal standard of beauty. Marilyn Monroe was hot, in my eyes. The woman in that photo just doesn't appeal to me; I can't imagine that she's very much fun to cuddle with.
I suspect it's also an extremely unflattering camera angle, and that she probably looks healthier than the photo shows. I don't think it's photoshopped, though-- I think that's an actual photo.