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The Oscar-winning actress admits in her new memoir Then Again that when she started out in the business, her poor self-image drove her to bulimia, Us reports.
"I was friendly looking, no Candice Bergen. The smile maybe, was all I had," she writes, referring to the blond bombshell who also became a star in the 1970s.
Keaton, 65, reveals she was 19 when she began to binge and purge. In 1965, a Broadway director cast her as the understudy for Sheila, the female lead in the musical Hair -- but only if she could lose 10 lbs. (There's a legendary nude sequence in the production's second act.)
Desperate for a shot at the role, Keaton did what she thought was necessary for the part. But her weight loss began a five-year battle with the serious eating disorder.
Keaton writes that psychotherapy helped her recover from bulimia and body dysmorphia. She reached a major milestone when one day she decided to not "open a half a gallon of rocky road ice cream."
After beating the bulimia, the Annie Hall star went on to star in her breakout role as Kay in Francis Ford Coppola's The Godfather, met Al Pacino, her first of several A-list partners. And the rest is...in the memoir, which will be published Nov. 15.