She seems ok when I've seen her interviewed. Quite self depreciating; humorous even.
Yes, she very (far too) thin. I think people can be very cruel about her. She seems vulernble and insecure. VB seems to concentrate more and more on her image the less she knows how to handle all the rest. It's something she can control.
Re the make-up. I bet it didn't look that bad in RL. When you have a flash picture taken at night, your face always looks very pale wearing makeup next to any exposed neck/bare shoulders.