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Nerea was diagnosed with anorexia nervosa when she was 14. At 5, she began to hear voices in her head encouraging her to stop eating. (David Arribas)

Drawings about self-perception made during a session with a psychologist. (David Arribas)

This past fall, The Washington Post partnered with Visura in an open call for photo essays. The Post selected two winners and three honorable mentions out of hundreds of submissions. We are presenting one of the honorable mentions today on In Sight: Spanish photographer David Arribas’s project on anorexia, “Jaula (Cage).”

Based in Madrid, Arribas pursues in-depth projects of an anthropological/social bent. He has examined Spain’s tradition of using greyhounds in wild hare hunting and produced a documentary on people and suicide, among other projects. Arribas’s “Jaula (Cage)” follows the story of a young woman named Nerea who struggles with anorexia nervosa.

According to Arribas, Nerea was 5 when she heard voices in her head encouraging her to stop eating. At 14, she was diagnosed with anorexia.

Millions of people around the world have eating disorders. Anorexia is probably the most well known because of the striking visual characteristics that accompany extreme cases. People with anorexia deprive themselves of food because they have an overwhelming fear of being overweight and can become extraordinarily thin.

Nerea told Arribas that she decided during her happy childhood that she wanted to be thin when she grew up. But at the onset of adolescence, she told Arribas, “the body I developed did not match what I had set out to do as a child, so I had to remedy it.”

The remedy for Nerea meant losing weight. Little by little she stopped eating. She liked the feeling of losing weight, and she set goals for herself to lose more and more so that she could grow thinner and thinner.

Now in recovery, Nerea tells Arribas that she realizes the positive feeling she got from losing more and more weight was just an illusion. She says she is aware that anorexia was like a virus: for it to live in her body, she had to keep shrinking.

The disorder took a toll on Nerea. She told Arribas she lost friends and had problems with her family. On top of it all, she was dying from the disease, but, even then, a voice in her head kept telling her: “You are the best anorexic in the world. You are doing great.”

Nerea knows she will have to deal with the effects of anorexia for a long time. As she told Arribas: “Even in my recovery process, I still hear voices telling me things like that, encouraging me to throw in the towel of life, and I know that there will probably always be an anorexic part inside of me, but there is also one that fights for life, and won’t tire of doing so.”

You can see more of Arribas’s work on his website.

Family involvement is fundamental when it comes to making alterations in relationships and changes in eating habits coordinated with a therapeutic team. (David Arribas)

The hidden use of reducing creams, fat and lipid burners, laxatives, diuretics and other products for weight loss is common. (David Arribas)

Once a month, Nerea is weighed at the doctor’s office. Butterflies are a familiar symbol in the world of anorexia because they represent something delicate, fragile and beautiful. (David Arribas)

Nerea’s father expresses frustration. (David Arribas)

The act of eating is sometimes difficult for Nerea, but it has to be faced every day. (David Arribas)

Checking one’s body in the mirror to make sure weight hasn’t been gained can become an obsessive compulsion for people with anorexia. (David Arribas)

The Internet can be a danger for people with anorexia because of the many websites that promote eating disorders, such as “pro-ana” (pro-anorexia) and “pro-mia” (pro-bulimia). (David Arribas)

Those with anorexia may perform rituals to control their bodies, during which body forms have to complete a series of patterns. They are actions that have been carried out in a compulsive way for a long time, and become involuntary. (David Arribas)

Nerea’s family checks daily to make sure she is taking her medications. (David Arribas)

Communication is fundamental so that Nerea feels comfortable talking about what she is going through. (David Arribas)

Nerea sometimes becomes overwhelmed. (David Arribas)

A portrait of Nerea. (David Arribas)

Nerea at home. (David Arribas)

In Sight is The Washington Post’s photography blog for visual narrative. This platform showcases compelling and diverse imagery from staff and freelance photographers, news agencies and archives. If you are interested in submitting a story to In Sight, please complete this form.

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