Sopranos Star's Bulimia Battle

In 1997, Jamie-Lynn Sigler looked as if she had everything on track. HBO had just picked up "The Sopranos," and Sigler, then an unknown high-school student from Long Island, was cast in a leading role: Meadow Soprano, daughter of the main mobster, Tony. But offscreen Sigler was struggling with an eating disorder, trying to "purge" calories by working out for hours at a time. In an interview with CNN, she recalled waking up at 3 a.m. to exercise four hours before heading to school, then drastically cutting calories during the day. When Sigler dropped from 120 pounds to 90, her parents became concerned and turned to a nutritionist and a psychiatrist for help. Sigler was able to overcome her eating disorder, an experience she writes about in her autobiography, "Wise Girl," published in 2002. She now serves as a spokeswoman for the National Eating Disorders Association (NEDA) and has created the Jamie-Lynn Sigler Foundation to help promote healthy body image and to raise awareness about eating disorders.

Approximately 11 million Americans have an eating disorder, according to NEDA. And they can be deadly. As many as 5 to 20 percent of those who suffer from anorexia nervosa, severely restricting their diet to maintain an unhealthily low weight, end up dying as a result-either from starvation, cardiac arrest or other medical complications, or suicide. While anorexia nervosa and bulimia nervosa (regularly binge-eating and then purging the food) are often thought of as the main eating disorders, other conditions have become progressively more common. Exercise bulimia, the eating disorder Sigler suffered from, is of increasing concern on college campuses, which often have 24-hour gyms and minimal supervision of exercisers. Binge eating-defined as single bursts of uncontrolled eating that last less than two hours and occur at least twice a week-has also become a concern after a study published this year in Biological Psychiatry found it to be the most common eating disorder in the United States.

Most research indicates that eating disorders go far beyond an obsession with food; they often represent a way of coping with a need for control over the environment. A 2004 review of eating disorder research found that some of the most common risk factors are elevated concern with weight and shape, as well as a negative self-image. Lately there has been sizable interest in how genetics may contribute to the start of eating disorders, with researchers finding a genetic predisposition to anorexia nervosa and bulimia.

Eating disorders are often treated with visits to psychiatrists and nutritionists. If that method does not work, patients may opt for a live-in treatment program, although some insurance providers have been reluctant to cover such treatment.