Bio Treatments for AN

AO1 - General overview of biological treatments for AN

• Biological treatments for anorexia nervosa (AN) mainly involve drug therapies such as SSRIs, tricyclic antidepressants, and antipsychotics like olanzapine.

• Tricyclic antidepressants (e.g. amitriptyline) increase serotonin and norepinephrine levels but are less commonly used due to severe side effects.

• According to NICE guidelines, drug treatments should not be used as a primary treatment for AN, but alongside psychological therapies such as CBT.

AO1 - Olanzapine

• Antipsychotics such as olanzapine are used to treat anxiety and distorted thinking.

• They work by blocking dopamine (and sometimes serotonin) receptors, which may reduce anxiety around weight gain and support weight restoration.

AO1 - SSRI’s

• SSRIs (selective serotonin reuptake inhibitors) are used to treat comorbid depression in individuals with AN.

• They work by blocking the reuptake of serotonin in the presynaptic neuron, increasing serotonin levels in the synaptic cleft and improving mood.

• This can reduce depressive symptoms and allow patients to better engage with psychological therapies.

AO3 - Supporting evidence (olanzapine effectiveness)

• One strength of biological treatments is supporting evidence from Jensen and Mejlhede.

• They reported case studies of three patients treated with olanzapine, showing improvements in body image and weight gain.

• This suggests antipsychotics may reduce distorted thinking and help patients tolerate weight gain.

• This supports the AO1 explanation that targeting neurotransmitters (dopamine/serotonin) can improve symptoms of anorexia.

• However, this is based on case studies, meaning findings lack generalisability and may not represent the wider AN population.

AO3 - Critique

• A limitation is that drug treatments can have significant side effects, particularly in individuals with AN who are already physically vulnerable.

• For example, rapid weight gain and increased anxiety in early treatment may worsen distress, as weight gain is a core fear.

• This may lead to non-compliance, where patients stop taking medication, reducing treatment effectiveness.

• Therefore, even if drugs are biologically effective, their real-world usefulness is limited if patients do not adhere to treatment.

AO3 - Supporting evidence (SSRIs – relapse + maintenance)

• Further support comes from Kaye, who found that patients taking fluoxetine were more likely to remain in treatment and had lower relapse rates.

• This suggests SSRIs may be effective in maintaining recovery rather than initiating it.

• This links to AO1 as SSRIs increase serotonin, improving mood and reducing depressive symptoms that may trigger relapse.

• Therefore, biological treatments may play a supportive role in long-term management of anorexia.

• However, Ferguson et al. found no significant differences between patients taking SSRIs and those not taking them in terms of weight gain or symptom improvement.

• This challenges the effectiveness of biological treatments, suggesting they do not target the core features of anorexia such as restrictive eating and body image distortion.

• Therefore, drugs may only treat comorbid conditions like depression rather than anorexia itself, limiting their overall usefulness.

AO3 - Other explanation (non-bio treatment)

• Psychological therapies such as CBT offer an alternative treatment approach.

• CBT targets maladaptive thoughts about body image and eating behaviours, directly addressing the cognitive causes of anorexia.

• This contrasts with biological treatments, which mainly target symptoms rather than underlying causes.

• Therefore, this suggests that biological treatments alone are insufficient and are most effective when combined with psychological therapies.

AO3 - Application

• Biological treatments have practical applications as they can stabilise patients by reducing anxiety and depression.

• This allows individuals to engage more effectively with therapies such as CBT, improving overall treatment outcomes.

• They may also be useful in inpatient settings where weight gain and medication use can be closely monitored.

• This shows that biological treatments are useful as part of a combined treatment approach rather than standalone interventions.

AO3 - Reductionism

• Biological treatments are reductionist as they focus only on neurotransmitters and ignore psychological and sociocultural factors.

• Anorexia is a complex disorder involving cognition, culture, and environment, which drugs alone cannot address.

• Therefore, a more holistic approach combining biological and psychological treatments is likely to be more effective.

AO3 - Psychology as a science

• A strength of biological treatments is that they are developed using scientific methods such as randomised controlled trials.

• This means they are evidence-based, objective, and tested for effectiveness and safety.

• This increases the credibility of biological treatments within psychology.

• However, the lack of consistent findings (e.g. mixed SSRI evidence) suggests that the scientific evidence base is not fully conclusive.