When you use the direct implementation of Anatomist Python API, more features are available. Indeed, each C++ class and function that are declared in the SIP bindings are available in Python. Moreover, the Python script and Anatomist objects share memory, so lower level manipulations are possible.
See the Anatomist doxygen documentation about the C++ API to have more information about the classes and functions that may be available in Python (if the bindings are done).
In this mode, it is also possible to interact on objects directly and interactively with Python Aims API. See more details about that in PyAims / PyAnatomist integration part in Aims tutorial.