Physical issues?
Physical issues could be an eating disorder. She looks borderline anorexic to my eyes.
Regards, Ivan
"Physical" issues is what stuck out at me. I started wondering if she's carrying a love-child, perhaps is suffering the effects of an STD, is physically dependent on something, suffering from anorexia, etc.
Then, I just decided to do a search, and found this:
http://search.ebay.com/wilbanks-wedding-invitation_W0QQfkrZ1QQfromZR8
I doubt it will ever end!
-Goron