Fools — i.e., infatuated in wickedness. (Comp. the noun foolishness in Psalms 38:5 with the same ethical sense; and comp. Job 5:3 and the frequent connection of folly with sin in the book of Proverbs.) Another Hebrew word is used in the same way (Psalms 14:1).
Because of their transgressions. — Better more literally, because of way of transgression, or, their course of sin, indicating a settled habit.
Are afflicted... — Properly, brought (or bring) affliction on themselves. LXX. and Vulgate, “were humbled;” and some understand “afflict themselves” — i.e., grieve for their sins. This would explain the distaste for food in the next verse equally well as actual sickness. But the analogy of the other stanzas is not in favour of indicating repentance before the emphatic “then they cry,” &c.