( Wait, weren't you the one who complained about how girls are expected to be thin in society these days and stuff? *gasp* )

Well, the pose doesn't look painful to me, rather the anorexia.
But don't let my sarcasm throw you off... it's well made. Nice coloring. Could use more vivid colors on the hair that make it look less like it was a single mass... and, try covering the upper or lower half of her body with your hand and look at it... I'm not sure whether it's just me ( can't say I'm an expert on the anatomy of female shoulders, breasts and necks ), but the halves look a little like they don't belong together.

Hope you didn't mind the criticism...