In this verse the relation between the psalmist’s groaning in line a and his emaciated condition in line b is taken by Revised Standard Version and others to be that of cause and effect, which seems strange. (But see Delitzsch: “Continuous straining of the voice … does really make the body waste away.”) Briggs takes line a to explain the reason for forgetting to eat food (in verse 4b). But it seems better (with New English Bible) to take the literal “From the voice of my groaning” in a general sense, to indicate the suffering, the illness, which makes him groan and which is the reason for his emaciated condition.

Good News Translation “nothing but skin and bones” translates “my bones stick to my flesh”; most take this to mean complete emaciation. The English expression “skin and bones” is a doublet indicating an emaciated physical condition. In some languages such a condition is spoken of as “having a stick body,” “having sunken eyes,” or “body of ribs.”

Quoted with permission from Bratcher, Robert G. and Reyburn, William D. A Handbook on the Book of Psalms. (UBS Helps for Translators). New York: UBS, 1991. For this and other handbooks for translators see here .