These adjectives refer to extreme thinness in which the underlying bones are evident. Bony is the most general word and is relatively free of connotations. It simply indicates a prominent bone structure, whether this is deemed a sign of attractiveness, asceticism, chronic undernourishment or near-starvation: a crooner’s bony , boyish face; a waif-like actress with bony shoulders and big eyes; a bony Indian fakir; a bony , sway-backed nag. Bony is frequently applied to a single part of the body: long, bony fingers; bony knees. And it may sometimes emphasize attributes of bone that are not seen but felt, such as hardness or sharpness: She jabbed me with a bony elbow.

Gaunt implies a paucity of flesh and prominence of bone. It comes from the Old Norse word for a tall, thin person and it indicates an angular leanness: the tall, gaunt figure of Don Quixote. Specifically, gaunt often calls to mind the haggard look of the hungry, anguished, ill or old. It suggests the weariness of long suffering or constant strain, describing one who seems to have been worn down to the bone: the gaunt , ascetic figure of a saint; a gaunt old man, hollow-eyed, with prominent cheekbones and attenuated limbs.

Wasted implies a loss of flesh, stressing the cause of bony thinness. A wasted body is one that has been gradually consumed ?reduced to skin and bone by the ravages of time, grief, hunger or disease: wasted away by tuberculosis; a pallid face and wasted frame. Hence wasted implies physical weakness and frailty; the wasted form of a 100-year-old woman; a body wasted by disease.

Emaciated focuses on both the cause and the fact of abnormal leanness. It indicates a previous wasting away, implying the depletion of the body by grave illness, great suffering or terrible deprivation. Skeletal is the most extreme of all these words, pointing to the deathlike dominance of bone. Both skeletal and emaciated may suggest the leanness of living men who look like skeletons, their ribs and sharp bones showing through the skin: emaciated (or skeletal ) survivors of a Nazi concentration camp. But skeletal has about it the further suggestion of something lifeless of unreal, not fully human or alive: a painting of skeletal men and women in a barren future world; a novelist whose characters seem to be skeletal symbols, thoroughly analysed but not fleshed out and never really brought to life. Emaciated , by contrast, is often expressive of human pity or horror at a skeletal appearance: the awful sight of emaciated children with distended bellies and glazed expressions.