Hmm. If food and sleep are addressed first, then if symptoms persist, you can proceed with looking for other causes of imbalance with the knowledge that food and sleep have been adequately addressed. If food and sleep are inadequate, this may produce the imbalances that appear superficially similar to psycho-spiritual distress, and sabotage effective treatment of the latter if it turns out to be the cause of the distress.
(Also, a person experiencing a major imbalance often works very hard to avoid conscious awareness of the cause of their distress - and so may insist that their poor diet/sleep habits/relationships/etc. are fine and incorrectly identify the problem as spiritual/energetic. A good medicine person will often have to trick the patient into doing the sensible, healthy thing by rationalizing it with the language of spirits/unseen forces.)
I should have qualified that with a "sometimes". But also, I should make sure I'm clear on what I meant by energetic. I mean the energy that runs through our electrical system, known as meridians. This is quite different from what I would classify as spiritual causes, and even spiritual doesn't have to mean spirits or unseen forces.
Yes, I agree food and sleep are often the cause. But there may still be underlying imbalances of a variety of kinds that prevent them from doing their job.