It doesn't matter, and I cannot believe "In Touch" was so desperate that this is a story that they felt compelled to do. Nearly every photo in any publication goes through Photoshop - that does not mean major alterations were or were not made.

This woman obviously has a mental health issue every bit as much as any anorexic or bulimic person, or even the woman who made the news for trying to be the fattest person. She needs treatment, not the glare of media focus. I am most concerned for her young daughter, like any child, her mother's issues are going to impact her life.