Genetic explanation of

anorexia and drug

treatments
AO1
• Read the description in your booklets…
• Make sure you explain what concordance rates are and how they
are studied in research with twins! (Look back over your bio notes
to help you)
• Google the term ‘heritable’ and add this into your third bullet
point
• This is a tricky explanation due to the new terms you have to
learn… Choose one key term or phrase for each bullet point that
you could use as a revision aid in a ‘describe’ question… I will be
checking this next lesson
Research support (there are 2 studies)
• P: There is research support from Holland et al (1988)
• E: They found a significant difference with a much higher
concordance rate in MZ twins (56% with 9/16) compared to
DZ twins (7% with 1/14). Further findings were that in three
cases in which the non-diagnosed twin did not have anorexia
they were diagnosed with other psychiatric illnesses and two
had minor eating disorders.
• E: This demonstrates… (think about what a higher
concordance rate in MZ over DZ shows!)
Research- anorexia… Turn this into a PEE
point… you may need to add in the final E
• Grice et al (2002) followed 192 families where one member
had been diagnosed with anorexia and at least one other
member had also received a diagnosis of any form of eating
disorder. In a subgroup of 37 families (where at least 2
relatives have been diagnosed with anorexia) there was
strong evidence for a susceptibility gene on chromosome 1 as
similar markers were found in the afflicted pairs.
Criticisms or credibility of research

• If there is a wealth of research that backs up the explanation it

can be seen as reliable. Complete the first PEE point in your
booklets.

• P: Low generalizability
• E: Who do twin studies use as their samples? Generally, twins are
from what sampling method? (Opportunity, stratified, volunteer,
random)? Use your bio notes to help you.
• E: This may not represent anorexia in wider society due to a biased
sample. Twins from a _____________ sample may have shared…
Criticisms or credibility of research

• P: Concordance rates are not 100%

• E: Reiterate the findings of Holland et al
• E: What does this demonstrate? If purely genetic, what would
concordance rates in MZ twins be? What therefore MUST play a role?

• P: Low validity
• E: Look back over bio notes… who are treated more alike MZ or DZ?
Why? What do MZ twins always share?
• E: We may therefore overemphasise the importance of genetic
factors.
Opposing research

• Fill in the blanks and format this into a PEE point in your
booklets!
• Wade et al.’s (2007) research on Australian female twins
showed that the families of anorexics and bulimics made
frequent comments about weight and shape whilst they were
growing up; and higher levels of paternal protection were
associated with anorexia whilst higher levels of parental
expectation were associated with bulimia. Thus, this shows
the role of __________________ and so is evidence that
anorexia is not just due to _______________.
Different theory

• WE WILL COME BACK TO THIS

Applications

• P: Has application
• E: If there are certain genes thought to cause AN then it can
help us to _____________ who may be at risk early on
• E: Can then put sanctions in place to ensure support these
individuals to lessen chances of AN occurring.
• HOWEVER… if AN is genetic… is this as useful as alternative
explanations? Why? Why not? Think back to the brain
abnormality explanation of sz. A good word to google here
would be EUGENICS.
• Leave the second application point for now.
+
• P: Highly credible & scientific
• E: How studied? Think about genetic testing itself and the
conditions in which it is carried out
• E: Therefore…
+
• P: Diathesis stress model may be important
• E: This explanation focuses solely on the role of… (reiterate the
genes/ markers said to be of importance)
• E: This is a r________________ explanation as it ignores the
impact of the environment, eg the role of role models in the media
in the onset of AN. This can be backed by a recent dramatic
increase in AN sufferers despite there being no major genetic
changes in the past 20-30 years.
Now jump forward to drug
treatments for AN in your
booklets…
AO1- drugs for AN
• This does not follow on neatly from the bio explanation for AN
that we study, mainly because the bio explanation we study would
not lead to a treatment!
• Genetic explanations of AN may lead to identifying those at risk,
where AN runs in families etc, but to get rid of the disorder
would be to remove the genes from the gene pool… and this would
be completely unethical! (Eugenics!!!)
• Instead, this treatment looks at addressing faulty
neurotransmission thought to cause the disorder… (you don’t need
to learn this as an explanation for AN though!)
The use of drugs in AN
• The NICE suggest that drugs are not used as a first choice
as they tend not to help with core symptoms, nor do they
promote healthy weight gain.
• Drugs are commonly used to treat the co-morbid symptoms
including depression, anxiety and OCD.
The use of drugs in AN
• There are two main types; SSRIs (anti-depressants) and
Olanzapine (an atypical antipsychotic).
• Anorexia is often associated with the neurotransmitter
serotonin; this is the neurotransmitter linked to mood and
the suppression of appetite.
• Low levels tend to be linked with depression too.
• Serotonin dysfunction can remain after recovery.
SSRIs

They work by blocking the reuptake of

serotonin in presynaptic neurones, making
more serotonin available in the synapse.
Fassino found citalopram (an SSRI) not to
help with weight gain but to aid the
depression and compulsions.
Antipsychotics

• These focus on dopamine production, suggesting that

altered dopamine functioning in the striatum may link to
anorexia.
• Research on the use of anti-psychotic is mixed- see the
research in your booklets.
Are they useful?

• Patients with co-morbid conditions such as depression and

anxiety may benefit from the use of medication as it
enables them to benefit more readily from psychological
therapies that are known to be effective.
• A patient with anxiety alongside anorexia is less likely to
drop out of therapy if they are also treated with drugs. If
the co-morbid conditions can be managed, it may make other
therapies more successful.
Practical issues to consider…

• As with schizophrenia,
• Who prescribes the medication?
• How might this be administered?
• How long might they be put on a drug for?
• Who decides upon the dosage?
• What if the drug doesn’t work?
Now evaluate… using the
DESSERT format! The
following slides will help
you.
Different treatment

• Come back to this after we look at TEPs next lesson!

Ethics and social control

• Look back to drug treatments for schizophrenia and

add in some points here… is the patient empowered
or in control of any aspect of their treatment?
Whose best interests are at heart through the use
of drugs?
Supporting studies

• Use the studies in your booklet to complete your PEE points

that have been started for you!
• However, much research evidence comes from small scale
studies using limited samples as drug treatments for
anorexia are not as widely used as other therapies. How
might this limit the generalizability of findings?
Side effects

• Google the side effects of SSRIs to treat anorexia and formulate

a PEE point in your booklets.

• Now have a go at turning this into a PEE point- this is the last
point that has been started for you in the side effects section!
• Patients taking SSRIs and olanzapine find that they gain weight
when they start taking the medication. This is the desired
outcome for patients with anorexia but might be a difficult side
effect for the patient to cope with due to the nature of their
illness. This may mean that patients struggle to continue taking
the medication if they are not receiving additional treatment.
Expense

• This is not a fantastic point in isolation, but if you

use this as a comparison it works. We can make a
comparison to TEPs (we will do these next lesson)
• Are drugs expensive compared to other treatments?
Why? Why not? (Look at your schizophrenia notes)
Reason or mask

• What does the treatment fail to address? What does

this mean in terms of effectiveness?
• P: The treatment does not address the psychological
cause of the disorder
• E: It treats the biological functioning of
neurotransmitters but ignores any psychological basis
for the disorder, eg size 0 models, cultural ideals etc
• E: Therefore, treatment might only be effective
whilst drugs are being taken- no long-term benefit
Time

• Not a great point in isolation but we can compare to

TEPs next lesson!
Going over genetic explanation of anorexia
(AO1)
• Ten times
• Concordance rates MZ and DZ
• Heritable
• Chromosome 1
• EPHX2
• Genetic markers
Going over genetic explanation of anorexia
(AO3)
• The socio-cultural explanation suggests that role models in the media
influence anorexia as anorexic individuals look up to such role models
and desire to be like them so imitate their eating behaviours.
• This is something the genetic explanation completely disregards; the
importance of the environment in the development of the disorder.
As such, it can be seen as _________________.