Wanting to 'set the record straight'

Since I published the post Confronting viewing" indeed a few days ago I have been having a lively correspondence with some of the people involved in the story, including the family. As should be expected, not everyone agrees on the value and quality of the piece. Accordingly, now the critique of the critique begins.

The psychologist shown in the 60 Minutes piece asked me to 'set the record straight' by sharing her perspective. Here it is:

Dear Laura,
Thank you so much for making contact with me. You are absolutely correct in your assumption that 60 Minutes presented a very oversimplified view of the treatment that Amy has received to date. As you suggested, Amy has had several admissions to inpatient anorexia specialist facilities for weight restoration both throughout Australia and internationally, in addition to the ongoing services she has received from me, her psychiatrist, other psychologists, psychotherapists, GPs and dieticians.

Of the 1 hr 15 minute interview I did with 60 Minutes, only approximately 2 minutes of footage was actually shown. Amy and her family have both acknowledged the facilitatory role they have played with anorexia, and although I have worked with the family to help them with limit setting around food and Amy's illness, Amy's extreme violence at home has made this very difficult for them (they also received treatment under the Maudsley Method prior to Amy being referred to me). Amy has also experienced significant periods of remission where she has been of healthy weight, worked, attended University and lived independently in the past four years, but none of the footage of myself or Amy acknowledging this was presented in the story.

Amy has also been refusing any admission to an inpatient facility for refeeding for the past 12 months, and as she is an adult (i.e. her parents don't retain legal guardianship of her), no medical professional could admit her until she was so medically compromised as to be admitted under an ITO.

The footage that 60 Minutes didn't show was that they actually provided financial assistance for Amy to receive overseas specialist treatment straight after the story went to air, which Amy was unresponsive to. She is now in a more medically and emotionally fragile state than before she accessed the overseas treatment, although she is currently in hospital under a refeeding program. I trust you understand that due to patient confidentiality, I am not in a position  to disclose any other details about Amy's struggle with anorexia, but I share your concerns about the oversimplistic portrayal of Amy's story (and the support she has received).

 Kind regards,.

Renae Beaumont BSc (Hons) PhD MAPS
Honorary Research Fellow
The University of Queensland, Australia


  1. Renae

    Thank you for your letter and explanation of the 60 minutes scenario.

    My daughter and I were on television earlier this year and I know they filmed us both for some four hours and the final segment was 90 seconds. However, I have to add that we were treated extremely well and sensitively by all at the BBC. We did live interviews too on both the TV and the radio and, although I didn't get to say everything I wanted (which would have taken about 2 hours!), they did treat us with great consideration and kindness.

    The ATDT forum is a good bunch of kind, loving, sensitive parents and carers and I fear that sometimes we may get a little fired up. The way the story was portrayed was obviously particularly detrimental to you and I jumped to a conclusion. I apologise.

    I am hoping that Amy's parents will be able to use the wonderful Feast resource and find help and support for the whole family and enable Amy to recover fully.

    Charlotte Bevan

  2. I am sad to hear about Amy's precarious physical and mental health. I hope her current refeeding program will be beneficial long-term for her. I was concerned to read about Amy's "extreme violence" at home, when presumably her family was trying to refeed her. Many of us who have children with EDs have been the target of physical violence. Even though sufferers who are emaciated from AN can't do much harm, I feel that such behavior must be immediately addressed, to keep everyone safe. I hope this was the case for Amy and her family. Ongoing extreme violence cannot be tolerated under any circumstances. In this case, I am assuming (correct me if I am wrong) that the violence pushed people away from the refeeding. That is exactly what the ED wanted.

    I hope that Amy's family can find some information, support and friendship on the FEAST, Around the Dinner Table forum for parents and caregivers of those with EDs. I have found it to be an invaluable resource in many ways.

  3. I also am very sad that Amy's health is further compromised and wish her well with the treatment she is currently undergoing.

    As someone who also did not manage to help my daughter to full recovery with the Maudsley Method and for whom the situation within the home became violent, I would hope that professionals and service providers can learn from Amy's story and from the many other similar ones and put into place suitable treatments that addresses both the starvation and its attendant challenging behaviours. Perhaps as a professional with considerable experience of such situations now Dr Beaumont you could work with others to bring such treatment to these patients and their families.

    Amy's parents would be very welcome on the Around the Dinner Table forum. If they (understandably) require some anonymity for now it is possible and fairly common to register under a pseudonym.

  4. Thanks for posting this Laura; it is helpful to obtain more insight to the film and to Amy's treatment regime to date within the bounds of confidentiality.

    It doesn't surpirse me that lots of filming was done, with lots of re-editing, cutting and pasting, to produce a final short film that was alarming and spread hopelessness rather than hope. A few years ago I agreed to be filmed about my history of AN. I agreed to do it ONLY if I could view the final version to be made public - and surprisingly this was permitted. However, I pulled out even before the film was made because although my intention had been for my story to be a recovery story, the woman who filmed me wanted me to stare out into the garden with a sad expression on my face and, worse still, to look at myself in the mirror and describe what I was seeing... (Please may I pause to puke...). I hate, hate hate it when AN is depicted merely as a woman staring at herself in the mirror pinching non-existent fat. I was unprepared to do 'compelling viewing'. I am quite a logical person who doesn't like showing emotions and I wanted the film to be informative and optimistic rather than an example of a tragic life story.

    In terms of Amy. I recognised such a lot of myself in her behaviours - when I was a teen. I calmed down a lot in my 20s but remained anorexic. I was not as physically violent as Amy, but I did threaten suicide. This threat wasn't 'for show' and neither was I being dramatic; I was terribly distressed and I meant it. And, like Amy I was emaciated and kept hundreds of food charts (later spreadsheets) with not only calorie values, but grams of each macronutrient. I also had (and have always had) bad OCD - which hasn't lessened with weight recovery. Insteads of obsessing over calorie/nutrient values I obsess over cleanliness and have reverted back to excessive cleaning and arranging.

    I do wonder whether people with this type of unremitting AN, who don't respond to the more tried and tested methods (like Maudsley need a different type of therapy - like the cognitive remediation therapy practised at IoP. I don't know enough about Amy, but I do know that my AN was underpinned by extreme OCD and autistic traits, as well as PTSD from childhood trauma.

    I do hope that Amy is able to recover. It took me until my 40s to do so and I often look back and wish I'd been able to do it in my teens so that I wouldn't be left with physical disabilities and missed opportunities.

  5. I also corresponded directly with Renae Beaumont after this piece was aired on TV. She is affiliated with the University of Queensland in Brisbane, Australia.
    Of concern to me is that her university's website lists "relationships with family" as one of the leading "causes" of eating disorders. http://uq.edu.au/student-services/Eating+disorders This is a very old-fashioned view, one that has not been supported by evidence. Most leading experts now reject the view that families "cause" eating disorders. See, for example, the Practice Guideline of the American Psychiatric Association, which states that "No evidence exists to prove that families cause eating disorders." http://www.psychiatryonline.com/pracGuide/pracGuideTopic_12.aspx As the APA concludes in the Guideline, not only is there no evidence, but implying that families are causal does harm to sufferers and families alike.
    I asked Ms. Beaumont to offer proof to support the contention that relationships with families cause eating disorders. She sent me one paper. It merely hypothesizes, however, that family interactions can maintain (not cause) the illness, a hypothesis for which it offers no substantial or convincing evidence. Consequently, I asked Ms. Beaumont to use her influence at University of Queensland to try to have the contention that families "cause" eating disorders in their loved ones removed from the university's website. She responded that she doesn't have control over the information presented on the UQ website. I find this response unsatisfactory. She is listed on the UQ website as holding a position at that university, and the signature line on her note to Laura identifies herself as affiliated with UQ. It seems to me, therefore, that she should be able to use her influence to at least try to get this statement removed, if she wanted to. This leaves me wondering: why would a major university, like University of Queensland, want to provide the public with a piece of information about a serious illness that is both not supported by evidence and is thought by leading experts to be therapeutically harmful? Why would a clincian affiliated with that university not want to try to help make the university's website as reliable and helpful as possible?

  6. According to the University of Queensland's website Dr Renae Beumont's PhD research and main published research are on Asperger's syndrome:


    Interesting - methinks...

  7. Dr. Renae Beumont seems to be affliated with the University of Queensland through her work on Asperger's syndrome rather than EDs.

    I have read the info on the University website cited by 'anonymous' above and without wanting to 'open a can of worms', or be too pedantic, a 'trigger' is not the same as a 'cause'. EDs do 'take on a life of their own' as a consequence of starvation, purging, bingeing etc. Disturbed family relationships don't necessarily mean abuse or neglect, it can include a variety of issues such as divorce, separation, illness in parents/siblings, effects of redundancy etc. - which could trigger anxious behaviours in a child. And, when an ED develops the result can be difficult family relationships.

    There are many different triggers for EDs and often ED sufferers come from very secure and loving families. Therefore there is no firm cause-effect relationship - which may underpin the APA conclusion that: "No evidence exists to prove that families cause eating disorders."

    We're down to semantics here... does 'cause' mean 'trigger' and vice versa?

  8. Dear F.E.A.S.T members,
    Thank you for the kindness and support you have shown towards Amy and her family. In response to the comment regarding the UQ website that has been posted, I have contacted the UQ student support services to request that the reference to family relationships being a potential cause of anorexia be amended. I initially assumed this content had been posted by another lecturer at UQ,in which case I have a limited capacity to authorise any changes to their website content.

    I would like to sincerely thank you for the support and compassion you offer to desperate families who are fighting to help their children win the war against anorexia.

    Kind regards,
    Dr Renae Beaumont

  9. I wonder if placing Amy under a guardianship order for a period of time - i.e. the tribunal enduring legal guardianship over her by reason of impaired capacity and lack of ability to meet one's own needs - would be of any significant assistance in putting Amy through lengthy re-feeding (full weight restoration, rather than simply physical and medical stabilisation) to the point where she may be able to think it a more rational and cognitive manner to address the underlying psychological causes of her anorexia. It certainly has been done in Australia before, in various cases with great success.

  10. WIth regard to the comment from 'anonymous' immediately above: Dr Beumont explained that Amy HAD been previously re-fed to a healthy weight (and had managed to live independently and work). There is no evidence to suggest that she had only been medically stabilised. As Dr Beumont said in the film, Amy has an obsessive-compulsive personality style. Given Dr Beumont's specialism Amy's obsessive-compulsiveness may be symptomatic of a neurological/developmental disorder. We do not know and can only speculate on the basis of the evidence we have.

    I have Asperger's syndrome as well as having been anorexic. I am no longer anorexic and have been weight restored for 3 years; but I can tell you that I have needed a lot of focused one to one therapy to enable me to cope in the world. Whenever I feel unable to cope I have the urge
    to restrict food again - and that urge is powerful. Refeeding has helped a lot, but it's the therapy that's helped most.

  11. There is a lot of evidence that qualifies therapy as being by the wayside in a profoundly malnourished patient. The brain needs to be fed and functioning for therapy to be of any significant, lasting benefit.

    It has been stated that as Amy is of adult, consenting age, no one can force her to gain weight or be re-fed, which is of vital importance in addressing her obessive-compulsive personality (which is a psychiatric disorder of it's own.) A guardianship order would not allow Amy to withdraw from treatment at any stage and therefore she could be re-fed and engaged in psychological therapies that may be of significant benefit to her.

  12. Anonymous (above), I agree that therapy is quite futile at low weights. My own psychiatrist emphasised the importance of an adequate increase in weight before 'real' therapy can begin. Hence, I gained 25 pounds before I had much therapy. However, the therapy itself was what really helped me. If I had just been re-fed then sent away I'd have relapsed immediately.

    The main point I was making above was that there was no evidence in the film or Dr Beumont's comments that Amy had only been partially re-fed. We don't know how 'well' or 'fully' she'd been re-fed or how long she had maintained a healthy weight. In fact there's a lot we don't know about her case which is why, perhaps, we shouldn't judge her treatment. However the film itself was poorly edited and somewhat biased.


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