Marianas Trench - Skin and Bones Lyrics Meaning

The song is about Josh Ramsay's struggle with eating disorders, specifically bulimia.

The opening verse describes him running water in the bathroom to cover up the sound of him vomiting, so that no one can tell what he's doing (turn all the water on/ and bury that sound/ so no one hears anything anymore). On some level he knows that he is sick, and that the reflection he sees in the mirror is lying to him and not really showing him the damage he is doing to his body (mirror lie to me/ tell me you can see/ maybe you won't be able to recognize me now).

Most of the lyrics make references to vomiting. In the chorus, Ramsay sings 'make me skin and bones' - which is generally the goal for people with bulimia - and talks about always being 'on my knees for you', a reference to kneeling in front of a toilet to throw up. He also talks about the burning sensation and the mess created by vomiting (sometimes it burns/ maybe I'll wash it out).

Ramsay also talks about the stigma of having an eating disorder. He is not able to get help for his problem because of the shame he feels for having one (it's easier to quit/ harder to admit). Untreated bulimia can eventually cause bleeding in your esophagus, something he references in the song (laughing like it works/ bleeding like it don't hurt). Although he knows his disorder is driving him to physical ruin, he is not able to stop because his body image issues are so deeply ingrained in him (I hate how I need you) (and you always win).