Here this might help. This is the news article that accompanied the pic.
foxnews.com

Bush was receiving the King Abdul Aziz Order of Merit and was bending his head down so that the medal could go over his head. Here is the description of the medal: “For meritorious service while in government office, for extraordinary deeds of bravery, and for other deeds of service to the state.”
medals.org.uk

One can argue that this is no less an insult to the U.S. than is bowing to the Saudi King, but it is disingenuous to present the picture as Bush “bowing” before the King.