As per Jay Allen's comment, if you are using Movable Type 4, make sure you have a cronjob with this in it:
cd /path/to/mt; ./tools/run-periodic-tasks
(where /path/to/mt is where Movable Type is installed)
This will make sure Movable Type clears out its session data and so it won't eat your database for lunch. It also does a whole load of other magical things, especially if you have plugins, but keeping your session data in check is one of them. I thought I had this in place but it turns out I didn't - hence why I ended up with several hundred megabytes of session data.

Great tip. I wonder if everything that run-periodic-tasks does is documented somewhere? A quick search on movabletype.org doesn’t immediately reveal any goodies except for handling the publishing of future posts. I’d love to know what the “other magical things” are ;-)
Well in my case it pulls in feeds and republishes them (on a part of the site I haven’t launched yet) and also fetches comments from FriendFeed, in case someone comments there rather than here.
Oh right, excellent. I think I really meant what does run-periodic-tasks do out of the box for everyone i.e it obviously clears session data based on your blog post so I was just wondering if that (and any other magical task it performs) was documented somewhere. A quick google of run-periodic-tasks doesn’t seem to provide anything of interest unfortunately.
I’m glad to hear that run-periodic-tasks takes care of this. You had me worried! I already have it running every five minutes, so I’m good.