The adjective has 4 meanings:
Meaning #1:
sounding as if the nose were pinched
Synonyms: adenoidal, nasal
Meaning #2:
very thin especially from disease or hunger or cold
Synonyms: bony, cadaverous, emaciated, gaunt, haggard, skeletal, wasted
Meaning #3:
not having enough money to pay for necessities
Synonyms: hard up, impecunious, in straitened circumstances, penniless, penurious
Meaning #4:
as if squeezed uncomfortably tight
