The Integrated Biopsychosocial Model of Health and Disease
Dr. David Wiss
May 29, 2022
Engel’s Biopsychosocial model (1977) proposed an update to the prevalent biomedical model at that time to include psychosocial components of illness, with the hope of creating better patient understanding and care [1, 2]. Reductionistic medical models assume only physiological processes are causally relevant. Thus, the biopsychosocial model is seen as a patient-centered model that incorporates a broader context, to reflect the social responsibilities of disciplines such as psychiatry. How important!
Health is not simply about biology, which is in many ways structured by an individual’s psychology and the societal context. Engel advocated for physicians to evaluate all the potential factors contributing to illness, as well as the experience of being a patient. This model is used in fields such as health psychology, functional medicine, and increasingly in mental health.
The biopsychosocial model is grounded in General Systems Theory, which contends that all levels of organization are linked to one another in a hierarchical relationship: changes in one level affect changes in others . General Systems Theory orders the world into a hierarchy from the most elementary particles to the individual person, to social phenomenon, and the universe. Everything is connected!
The primary strength of the biopsychosocial model is the effort to investigate the multilevel interactions that contribute to health and illness. This includes genetic susceptibility, harmful biological exposures, childhood and adolescent experiences, socioeconomic status, personality, acute stress and chronic stress, lifestyle behaviors, social networks, and their combined effects on physiological functioning . We need to look at everything!
The biopsychosocial model provided the groundwork for the intersystem communication among the neural, immune, and endocrine systems in the context of psychopathology and related outcomes. The biopsychosocial framework has been referred to as a “revolution” bridging science and humanism while recognizing that medicine has been slow to incorporate psychosocial components such as emotions, family, and community contexts . While it is common knowledge that both illness and health result from interactions between biological, psychological, and social factors, true integration has not been achieved . Our goal is to achieve that integration.
At Wise Mind Nutrition, we utilize a biopsychosocial model in our nutrition education and transformational treatment program. We emphasize the biological impact of nutrition on the body, and the psychology of eating behavior, all viewed from the lens of the broader social and environmental context. This approach is critical to recovery from binge eating disorder, where discussions about weight stigma and weight bias at the societal level are critical.
Nutrition is the perfect example of a biopsychosocial discipline, particularly at the intersection of eating disorders and food addiction. We are here to advance this field forward and help people to understand nutrition in a new (and long overdue) way. Join the revolution and find innovative ways to reduce chronic stress and improve your mood and relationship with food.
1. Engel GL (1977) The need for a new medical model: a challenge for biomedicine. Science. https://doi.org/10.1521/pdps.2012.40.3.377
2. Engel G (1980) The clinical application of the biopsychosocial model. American Journal of Psychiatry 137:535–544
3. Novack D, Cameron O, Epel E, Ader R, Waldstein S, Levenstein S, Antoni M, Wainer A (2007) Psychosomatic Medicine: The Scientific Foundation of the Biopsychosocial Model. Academic Psychiatry 31:388–401
4. Smith RC (2002) The biopsychosocial revolution. Journal of General Internal Medicine 17:309–310
5. Wade DT, Halligan PW (2017) The biopsychosocial model of illness: a model whose time has come. Clinical Rehabilitation 31:995–1004