Did you know that weight stigma is the leading cause of stress and trauma for those with larger bodies? With ASDAH, you get equal access to healthcare and combat weight stigma. In this episode, Mia Greco, the Owner of Olive Branch Nutrition in Huntley, Illinois, takes us into nutritional counseling and shares her insights on intuitive eating and the Health at Every Size movement. She also discusses the role of ASDAH (Association of Size Diversity and Health) in equalizing healthcare and helping combat weight stigma. Mia’s insights brought to light the importance of nutritional counseling in dealing with eating disorders. Let’s join hand-in-hand in protecting our health and valuing nutritional counseling by tuning in to this episode with Mia Greco today.
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Mia Greco, MS, MPH, RD, LDN – Pioneering A Revolutionary Paradigm Shift In Nutritional Counseling
Mia Greco is the Owner of Olive Branch Nutrition. She pioneers a revolutionary paradigm shift in nutritional counseling, emphasizing holistic health and individual well-being over conventional diet culture. At Olive Branch Nutrition, she offers a safe, supportive environment where clients feel empowered to explore their unique nutritional journeys, free from judgment or weight-centric ideologies.
Her weight-inclusive non-diet philosophy is deeply rooted in the Health at Every Size movement, promoting body acceptance, intuitive eating, and honoring diverse bodies. She treats patients with eating disorders, disordered eating, and chronic disease using the weight-inclusive nutrition program. Mia’s academic background includes a Master of Science in Nutrition and a Master of Public Health degree.
Mia, welcome. It’s a delight to see you face to face.
Thank you, Dr. Tim. Thank you very much for having me here. I appreciate it.
I’m looking forward to hearing about how you got into the work you do and what drives your passion for it.
I am a registered dietician and own Olive Branch Nutrition, a weight-inclusive outpatient nutrition counseling practice specializing in eating disorder treatment. I have not always been in this line of work. I became a dietician several years ago, not solely for my passion for nutrition or my passion for healthcare but for my passion for chasing the thin ideal. I wanted to be a dietician. I myself could find the secret of pursuing the ideal body that society told me was important to have.
I worked in a traditional sense as a dietician for several years until the end of 2019, when I was at a family party, and my cousin’s wife introduced me to the concept of intuitive eating. Intuitive eating is a set of principles that were developed by dieticians Elyse Resch and Evelyn Tribole that helps people heal their relationship with food. When I discovered intuitive eating, I recognized that I had had a disordered relationship with food and my body for most of my life. I had finally recognized that striving for the thin ideal wasn’t something that I wanted for myself or for the community that maybe I could serve.
In leaning into learning more about intuitive eating, I also stumbled upon the social movement of Health at Every Size, which means that instead of prioritizing weight loss and weight as a goal of health, it focuses on health behaviors for people of all different sizes. Armed with this new knowledge, I worked on healing myself and my relationship with food and making peace with food. I developed the passion that led me to open my business, which is Olive Branch Nutrition.
I began seeing patients in 2020 and solely evolved to working mostly with folks struggling with binge eating disorder, anorexia, bulimia, orthorexia, disordered eating, and chronic dieting. My personal passion is to become thin and have disordered eating. Becoming a dietician took 180 when I discovered intuitive eating, which led me to build my private practice in helping people discover food freedom the way I had for myself.
It’s only been several years that you’ve been on the intuitive eating path and Health at Every Size. Is that the second one?
Yes, that’s correct.
Give me an overview of how you would say what you’re doing now is significantly different from what you did for the first several years as a dietician.
In the first several years as a dietician, I worked primarily in long-term care. It was a weight-centric model. We utilized BMI to determine if a patient was overweight or obese, as the medical term is utilized, and based our interventions primarily on weight.
BMI is Body Mass Index.
The entire medical community is discovering that it’s not a good measure or indicator of health at all. That’s the premise of Health at Every Size. This body mass index is bogus. It lumps people into categories that aren’t necessary. It’s not truly measuring health like lab values or other measures of health that are more than taking your height divided by your weight and don’t account for body mass or composition.BMI is not a good measure or indicator of health at all. It's not measuring health. Other health measures are more than just taking your height by weight without accounting for body mass or composition. Click To Tweet
That was the weight normative approach. I was primarily working in facilities. I was monitoring my own health based on my weight. I was still engaging in disordered eating throughout my entire life until I discovered intuitive eating several years ago. Now, my approach is weight inclusive, meaning I focus with my patients on their health behaviors, healing their relationship with food, and adding gentle nutrition.
With patients in larger bodies, we’re not focusing on the number on the scale. We’re focusing on how they feel in their bodies. Are they nourishing their bodies consistently? Are they eating foods that make them feel good? Are they engaging in a movement that they love? Are they getting enough sleep? Are they taking the medications and supplements that were prescribed? Taking that focus off of weight often makes these health behaviors more sustainable. That’s how it’s completely different from the traditional model of dietetics care.
In the traditional model of dietetics care, is it that you’re trying to help people cut down how many calories or how much fat they’re consuming and watching how that translates to a change in the scale?
Not always, but that’s certainly a component of care. There’s more to medical nutrition therapy, but oftentimes, one of the goals is weight loss. That’s part of a typical nutrition intervention. If someone is in a larger body, automatically, the goal is something that is measurable. Let’s lose 10% of body weight by X months. In weight-inclusive care, the weight would not be a goal, and a lab value might. If a patient has high cholesterol, cholesterol will certainly be of interest, but it would be more like, let’s lower cholesterol by this much by this time, rather than focusing on weight as a parameter of health.
The other thing I’m hearing about what you’re talking about is there’s a lot more focus on the mental and emotional relationship the person has with themselves, their body, and the food they’re consuming.
In my line of work, in particular, it’s not always about the food. It is focusing on that relationship, helping them to understand why they might be utilizing foods to comfort themselves or cope with their emotions, and helping them find space to cope with their emotions with kindness without utilizing food to numb that. Figuring out why they’re using food, tuning into people’s innate hunger cues and fullness cues, those might even be turned off. We’re helping them recognize what their bodies are truly feeling and enjoying and being satisfied with food without the emotional attachment to food.
When you mentioned those hunger cues with the individual, it might be turned off. A question might be, what could or might turn that off? The first thing I think about is trauma experience. Are there other things that might turn it off?
Trauma is a cause of that. Eating disorders are a form of dissociation. Other things that can cause this binge cycle are dieting or not honoring our innate hunger cues. When we’re part of diet culture, and we’re in larger bodies and forced to constantly try to shrink our bodies, we’re not listening or trusting our innate bodies’ cues. Our body’s hunger and fullness cues get completely skewed.
Returning to that innate, actual, natural hunger is an important process in healing the relationship with food because of the idea of restricting and not listening to your internal cues. Let’s say intermittent fasting is one that I like to talk about. People are not honoring their innate hunger cues when they’re hungry and only eating via a prescribed window. Their hunger as an adaptation to starvation becomes less knowledgeable. They’re used to bypass it. They don’t hear it and they’re not in tune with their bodies anymore. They trust the external clock rather than their internal innate cues. They stop working.
You mentioned dissociating. People like Peter Levine and the people who do somatic therapy have become aware that through the downloading of these traumatic energies, many people are walking around cut off at the neck. Whatever’s happening at the neck down, they’re not tuning into those cues, maybe for decades. Is that something that you try to work to address? If so, what kinds of tools do you have to help people address that?
It’s tough to increase interoceptive awareness. You have to tread carefully with it. Someone has to be ready to feel their body again after being disconnected for so long. In terms of eating, it is being mindful and aware. Start to enjoy your eating practice as a part of self-care. Sit down with your meal without distractions. Notice the smell and texture, and think about who had to touch this food in order for it to be in front of you, from the person in the field who harvested the wheat in your sandwich, from the person at the factory who works on the machines to the advertising company that put together the logo for the bag that the bread comes in.
Connecting to the food and the entire experience of eating is working towards trying to get that innate body trust back. It’s treading carefully on opening up those channels of feeling in your body. There are different exercises and tools we utilize in intuitive eating in regard to fullness. There are some exercises for drinking water, trying to feel the water and feel your belly expand. It’s not necessarily utilizing food but feeling what water feels like in your stomach, going back to those complete basics. It’s being non-distracted and completely in tune with your body to start building back some awareness.
Is your experience as the coach, the dietician, or the therapist in this process significantly different for you than it was before you got in this? If so, how?
As a clinical dietician in long-term care, it was black and white. It was numbers, meds, labs, anthropometrics, and data. I’m treating the whole person. I’m treating a body-mind connection. The work is much more fulfilling. It’s person-centered care. We’ve always talked about person-centered care in clinical areas, but there is nothing like doing this deep intensive outpatient counseling from, I wouldn’t say, a less clinical, but a less medical approach because you include mind and body. That wasn’t prevalent in the traditional model of care.
I need to take more classes. I have to expand my knowledge set in different therapies and get supervision that I didn’t necessarily need as much because of the whole psychological aspect of my work now, which is rewarding. It’s almost made me want to change careers a few times and go back to school to become a psychologist. I’m not doing it.
I can’t recommend that because you’re going to lose this other focus that you bring, this other energy field that you bring in when you come in from the knowledge of the diet, physiology, and nutrition that many people that I talk to, as medical doctors go through medical training, and they get no nutritional training.
No, they don’t. They get one class. They often do harm, unfortunately, not intentionally, but they don’t have the knowledge.
They don’t have that breadth of knowledge in that area. I would imagine that you’d be more effective in gradually expanding some of the supervision, classes, and things of a psychological nature or specific therapy interventions and blending that into that core that you already have. You’d be much more effective that way and do the things that a psychologist can’t without that training. I got a little bit of an idea about this intuitive eating, but what about the health at any size? How do you help me expand an awareness of what that’s about?
Health at Every Size is a movement that was coined by the Association of Size, Diversity, and Health. It’s based on the inclusivity of people of all sizes, shapes, and ethnicities, understanding the cultural influences of health and not everybody is able to be healthy. Your morality isn’t based on whether or not you are healthy. You’re not a good or bad person based on your size or your health status.
It’s offering accessibility to people for joyful movement, having positive spaces where people can engage in health-promoting behaviors without worrying about being discriminated against based on their size in particular but any other thing that might be challenging or an identity that might be considered oppressed against.
ASDAH has some great resources. They are working on revamping a lot of their policies and making sure that they’re as inclusive as possible, but they do have a Health at Every Size healthcare provider listing that’s on there where you can find practitioners, not only dieticians but therapists and doctors as well.
What is the website for that?
It’s ASDAH.org. There’s a listing area where you can find Health at Every Size healthcare providers and those that are focused on health behaviors rather than weight-centric policies. We do know that weight stigma is a leading cause of stress and trauma for those with larger bodies. This paradigm helps to address that. What ASDAH does is work towards racial equality because larger bodies are also a racialized topic. It’s even more oppressive for those people of color who are in larger bodies. They are trying to equalize the playing fields in healthcare, honestly.
The weight stigma is not prevalent. We’re not discriminating against people based on the size of their bodies, and everyone’s getting equal access to healthcare and the same treatment. Someone with a larger body should be getting the same treatment as someone with a thin body. The intervention is, “Go lose weight.” It should be, “Let’s get some physical therapy and strengthen your knees.” What ASDHA and Health at Every Size are working towards is equality and accessibility in all healthcare. It’s a cool organization.
I can tell the energy you have for talking about it. The grit is great. Do you know where they’re located or based?
Is it a chapter-based organization?
No, it’s a national organization. I don’t believe they have local chapters. I don’t see where their headquarters are. You can be a member. I am a member of ASDAH. You get the benefits of being in their hay listing. They have resources available. There’s a conference. They haven’t abolished the BMI coalition. They are focusing on working to get rid of BMI as a health parameter. They have members all over the world, but I don’t know where their local headquarters are.
I love the idea of a more inclusive picture of the person. That’s why I try to make the majority of interviews that we’ve done here for the show be with people who do at least integrative, if not functional medicine and/or holistic approach, from whatever their specialty is. It is beneficial to be able to integrate knowledge from different sources, looking at the whole person. It gets disjointed when we’ve got all these different specialists who aren’t communicating with each other. You can miss the entire cause function of something if you’re focused on one specialty.
That’s why it’s impactful for me to know their entire history, social history, and food history to collaborate with their team, especially with eating disorders care, and collaborate with therapists and MDs to make sure patients are medically stable. MDs often don’t know a lot about eating disorder care either.
I try to bridge that and educate them so they can provide the best care for their patients. Usually, they’re receptive because, as far as eating disorder-specific therapy, they know that there’s a little bit of a deficit of knowledge. The collaboration of care is essential in treating the entire person. It’s the way forward in healthcare. I hope we see more of that.The collaboration of care is essential in treating the entire person. That is the way forward in healthcare. Click To Tweet
When you mentioned this specific eating disorder treatment and care, my brain goes to all of the hospital programs that I’ve been aware of for the past several years of doing therapy that it’s a crisis and inpatient. Do you interact with people from those programs? Do you cross-refer? How do you get the patients that you deal with? Talk to me a little bit about that, if you would.
I do have some relationships with inpatient networks, therapists, and dieticians. I’m considered a step-down level of care. Once they’ve completed either a residential treatment program or an inpatient, maybe they go down to a partial hospitalization program and they do an intensive outpatient program. They come to me as an outpatient patient.
I’m seeing patients that are medically stable. We’re working towards maintenance and making sure that they’re weight restored. At times, I’m working with patients who are almost intermediate, where I might be working with them and recommending them for a higher level of care. They might come to me almost as a first resort, not wanting to go to concerned parents. As we work with them, they might need that greater support. I refer them to a higher level of care to get assessed. Oftentimes, they work their way back down to me again.
I do see patients. I’ve had some patients on my load almost since the beginning. I’ve had patients for several years. I’ve worked my way with them through all of those levels of care at times. It’s successful when I get to see them stay out of a higher level of care and continue to be stable with me for months. I hate to see them go, but I’m excited when they don’t need to see me at all anymore when they graduate completely.
How much of your work is done doing this interview virtually or through Zoom? How much is in person?
My practice is 75% virtual. I would like to be in person. That’s a variety of factors. It’s convenient. A lot of my adult clients love telehealth consultations because they can do it while they’re at work or on their lunch break. They don’t have to commute. The majority of my in-person patients would be my adolescent patients. They like to see me in person. They want to be here, which is interesting. Do you think the younger generation would be more acclimated to telehealth and prefer that? From my experience, they want an in-face connection. With most of my adolescents, I don’t see many adolescents virtually.
I would’ve thought the reverse. Let’s get centered here, take a breath, and think if we’re reaching the end of our time. If you scan what we’ve talked about already, is there something in it that you want to go back and highlight or something that I haven’t even asked you about yet that you want to put in this discussion?
It is understanding the importance of eating disorder therapy and mental health. In the nutrition world, there are many things out there that are pervasive in our faces regarding body image, especially for young women. Social media plays a huge impact in developing young girls’ self-esteem. If anyone can take anything away from this, be mindful that commenting on people’s bodies, things that they’re eating, or in general about appearance, good or bad, is to be used with caution as a warning because often someone is coming from.
I had a patient who was triggered by a neighbor making what she thought was a compliment. Typically, you say, “Look at you. You look great. You lost weight.” That comment led to a validation of her eating disorder behavior and increased her restriction in purging because it validated that it was “working.” Mentioning that being mindful of the things that you say to people regarding their bodies is something that we should be sensitive about and is contradictory to what we praise on a daily basis. It’s making that point as something added to get out there in the world.
It’s a big issue for us as individuals, but also certainly as a culture that we have some toss-off phrases about how beauty is more than skin deep, and yet there’s so much conditioning to focus on the size, the shape, and the clothes. When we do that, we miss who the person is.
You don’t hear, “She was such a pretty girl.” When there’s an untimely death of a young woman, you don’t hear the loss of all the other things that she was. It’s dehumanizing. It happens to men as well, but in particular, young women are viewed as objects first. Whether or not they’re beautiful is more correlated to their worth, whether or not they’re smart, athletic, or funny. We’re trying to reframe that from her being such a pretty girl to her being funny, kind, and wonderful. We’re taking it away from appearance-based standards, which we have a long way to go.
I love the idea of helping people. Gay and Katherine Hendricks are an older couples therapy team that has written books and been on internet television shows and the internet. One of the practices that was impactful early on when I started reading and listening to them was the idea of not saying to their partner, I love you, but making an appreciation list daily and sharing that with their partner. It is a practice that can be strengthened, that we talk about the different aspects of a person and how their life and behaviors impact me.
I can talk to them about what I appreciate about that, whether it’s thoughtfulness or gentleness. I appreciate how gentle they are with themselves or how they’re doing good self-care. If I ask them, “Can you help me with this?” They say, “I’d like to, but I have to.” I can appreciate they did what was best for them. That’s a good thing. If I’m going to start looking for and listing things I appreciate about a person, it brings me into that relationship with who they are more than that cursory, I love you, or you’re pretty.
I try to have people. I talk to them about what I appreciate about them. I encourage them to develop an awareness of their own traits that are valuable. There’s a way of looking at different stages in a relationship. When the relationship changes or ends, I have this little practice or tool that I call saying goodbye to good people without saying goodbye to good memories.
What that talks about is reviewing the relationship, at least up to here, or if the relationship ends the whole thing, and looking at what was challenging for me in this relationship. What was a blessing for me in this relationship? How did I grow because I wanted to be more like you in this aspect of humor, perseverance, or kindness? How did I have to grow because I had to adjust to the fact that you weren’t as kind as I wanted you to be at times? How do I think your life changed for the better by having interaction with me?
It’s this idea of digging into what it was like growing in this process of being in this relationship and getting clear about what I appreciated and what was of value. I encourage people to do that in their own lives and their current relationships, even if they’re not coming close to an ending, because it helps enrich the experience.
Would you think that that would work, enriching your relationship with yourself?
Yes, that’s the whole point. If I learn to make a list of what I value about myself, we’re all good at what I don’t like. We’re all good at all the negative self-talk, and even if, for some of the traumatized people I deal with, with the self-loathing. We’re not good at slowing down and noticing where we’re already succeeding, thriving, and being a blessing to ourselves and others.
That would work well with my patients with body image issues and recognizing that there’s so much value outside of that external validation, looking within for all those wonderful things.
We’ve been conditioned by our culture, so I would imagine a lot of the work you do is to help people understand their value, which is already there, and the culture doesn’t feed back to them or reward them for it. One of the things that I share with people is a Jewish Buddhist grandmotherly-type woman whose name will come to me. Anytime she had any negative emotional state, she would put her hand over.
Sylvia Borstein was her name. She’d put her hand over her heart, and she’d say, “Sylvia, you’re in pain. Take a few deep breaths, slow down, calm down, and we’ll look at what’s going on, and we’ll decide what to do. For now, Sylvia, you’re in pain.” I took from that tremendous value in my own personal work of being more gentle with myself on a regular basis because the whole picture of what I see shifts dramatically sometimes when I interrupt negative self-talk and when I can be gentle with myself.
Part of the work with my patients is helping them reframe that negative self-talk and, instead of with shame, look at it with curiosity. Where are those thoughts coming from? The shame spiral causes them to utilize more coping mechanisms. You’re utilizing foods in ways to punish themselves.
I greatly appreciate your willingness to share this stuff with us. Give me the acronym for that second website.
I’ll look into it myself. I have much gratitude for your willingness to share the work. Keep up the good work.
It’s my absolute pleasure. I like to shout it from the rooftops any chance I get. I’m passionate about it, as you probably can see. I’ve seen how it’s impacted me and all of my patients. Thank you for the opportunity to share it.
The website for your practice is?
Thanks for your time. I greatly appreciate it.
Thank you, Dr. Tim.
Mia Greco is the owner of Olive Branch Nutrition. She pioneers a revolutionary paradigm shift in nutritional counseling, emphasizing holistic health and individual well-being over conventional diet culture. At Olive Branch Nutrition, she offers a safe, supportive environment where clients feel empowered to explore their unique nutritional journeys, free from judgment or weight-centric ideologies.
Her weight-inclusive non-diet philosophy is deeply rooted in health at every size movement, promoting body acceptance, intuitive eating, and honoring diverse bodies. She treats patients with eating disorders, disordered eating, and chronic disease using the weight-inclusive nutrition program. Her academic background includes a Master of Science in Nutrition and a Master of Public Health degree.
Mia champions evidence-based, compassionate care, reshaping the narrative around health and nutrition. As a registered dietician and licensed dietician nutritionist, she empowers clients to foster a positive relationship with food, reject societal pressures, and embrace and nurture sustainable approaches to wellness.
Beyond her transformative work at Olive Branch Nutrition, Mia serves as an esteemed adjunct faculty member and clinical supervisor at Harper College. Her dedication to education and mentorship extends her impact beyond private practice, guiding future nutrition professionals toward a compassionate, inclusive approach to healthcare.
About Mia Greco
As the owner of Olive Branch Nutrition, Mia pioneers a revolutionary paradigm shift in nutritional counseling, emphasizing holistic health and individual wellbeing over conventional diet culture. At Olive Branch Nutrition, Mia fosters a safe, supportive environment where clients feel empowered to explore their unique nutritional journeys free from judgment or weight-centric ideologies.
Her weight- inclusive, non-diet philosophy is deeply rooted in the Health at Every Size (HAES) movement, promoting body acceptance, intuitive eating, and honoring diverse bodies. Mia treats patients with eating disorders, disordered eating, and chronic disease using the weight inclusive nutrition paradigm. Mia’s academic background includes a Master of Science (MS) in Nutrition and a Master of Public Health (MPH), Mia champions evidence-based, compassionate care, reshaping the narrative around health and nutrition.
As a Registered Dietitian (RD) and Licensed Dietitian Nutritionist (LDN), she empowers clients to foster a positive relationship with food, rejecting societal pressures and embracing a nurturing, sustainable approach to wellness. Beyond her transformative work at Olive Branch Nutrition, Mia serves as an esteemed adjunct faculty member and clinical supervisor at Harper College. Her dedication to education and mentorship extends her impact beyond private practice, guiding future nutrition professionals toward a compassionate, inclusive approach to healthcare.
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