Isabelle Caro, a French model and actress who became the international face of anorexia* when she allowed her ravaged body to be photographed nude for an Italian advertising campaign to raise awareness about the disease, died on Nov. 17. She was 28. Her friends and family initially kept her death secret. Danièle Gouzard-Dubreuil-Prevot, Ms. Caro’s longtime acting instructor, informed The Associated Press on Wednesday that she died after returning to France from a job in Tokyo. Though her anorexia was almost certainly a factor in her death, its exact role was not clear, and her weight at her death was not known. But Ms. Caro weighed only about 60 pounds when she posed, reclining and staring balefully over her right shoulder, for an advertising campaign for the Italian fashion label Nolita in 2007. She was 5 feet 4 inches tall and had battled anorexia since the age of 13. The image, displayed on billboards and in newspapers as Fashion Week got under way that year in Milan, was shocking. Ms. Caro’s face was emaciated, her arms and legs mere sticks, her teeth seemingly too large for her mouth. In large letters, “No — Anorexia” ran across the top of the photograph. The photo was taken by Oliviero Toscani, celebrated in the fashion industry for his Benetton campaigns in the 1980s and 1990s, which included such provocative images as a close-up of a man dying from AIDS and prisoners on death row. The Nolita campaign came as the fashion industry was under a spotlight over anorexia, after a 21-year-old Brazilian model, Ana Caroline Reston, died from it in 2006. “The idea was to shock people into awareness,” Ms. Caro said at the time. “I decided to do it to warn girls about the danger of diets and of fashion commandments.” Some groups working with anorexics warned, however, that it did a disservice to those with the disorder. Fabiola De Clercq, the president of Italy’s Association for the Study of Anorexia and Bulimia, said that Ms. Caro should be in the hospital and pronounced the image “too crude.” The ads were eventually banned by an Italian advertising watchdog agency, which determined that they exploited the illness. The campaign gained Ms. Caro widespread attention in Europe and the United States. She subsequently served as a judge on the French version of the reality show “America’s Next Top Model” and worked periodically as a film and television actress. Ms. Caro often spoke out about her anorexia and her efforts to recover, including an appearance on the VH1 reality series “The Price of Beauty,” starring Jessica Simpson. Ms. Caro’s Facebook page said that she was born on Sept. 12, 1982. In her 2008 memoir, “The Little Girl Who Didn’t Want to Get Fat,” she described a tormented childhood dominated by the profound depression that gripped her mother, an artist, when Isabelle was 4. Obsessed with protecting Isabelle, her mother kept her out of school until the age of 11 and forbade her to play with other children, lest she pick up an illness. She often criticized her daughter for being too fat. “She wanted me to be her little girl forever,” Ms. Caro told Italian Vanity Fair in 2007. “So as I started puberty I hated the idea that my body was going to change. I wanted to have the body of a child forever, to make my mother happy.” As a result of her self-imposed diet, she would often lapse into comas and awake delirious, not knowing who she was. At one time, she survived on one square of chocolate a day with a cup of tea that she consumed a teaspoon at a time, to make it last. Ms. Caro’s long struggle with her disease had alarming ups and downs. In 2006, when her weight dwindled to 55 pounds, she sank into a coma. After months in intensive care, she was advised by a psychologist to break free of her parents, and she moved to Marseille. She also began a blog documenting her struggle with anorexia. “I still eat almost nothing, but I’ve stopped vomiting,” she said after her photo shoot for Nolita. “I have started to distinguish tastes of things. I have tried ice cream — it’s delicious.” This March, she announced with pride that her weight had risen to 93 pounds. The Swiss singer Vincent Bigler had been working with Ms. Caro on a video for a song he wrote about anorexia called “J’ai Fin,” a wordplay in French that means roughly “I am the end” but has the same pronunciation as “I am hungry.” He said he wrote the song after being so moved and worried by seeing Ms. Caro on television. Mr. Toscani said that he had visited several hospitals in France, Italy and Germany to find the right model and chose Ms. Caro because she exhibited the classic physical characteristics of advanced anorexia and because her eyes were haunting. http://www.nytimes.com/2010/12/31/world/europe/31caro.html * Anorexia nervosa is an eating disorder characterized by refusal to maintain a healthy body weight and an obsessive fear of gaining weight, often coupled with a distorted self image, which may be maintained by various cognitive biases that alter how the affected individual evaluates and thinks about her or his body, food and eating. Persons with anorexia nervosa continue to feel hunger, but deny themselves all but very small quantities of food. The average caloric intake of a person with anorexia nervosa is 600-800 calories per day, but in extreme cases self-starvation is more extreme. It is a serious mental illness with a high incidence of comorbidity and the highest mortality rate of any psychiatric disorder.