What is S.T.E.P.S. to Nourishment™?
S.T.E.P.S. to Nourishment™ is a proprietary, evidence-based nutrition framework developed by licensed dietitian-nutritionist Miriam Wiener, MS, MPH to address — or even reverse — weight-loss resistance and other chronic conditions. Participants learn what each component is, why each is so important, and exactly how to apply it for the fastest, most effective results.
Do you accept insurance?
Our S.T.E.P.S. to Nourishment™ Telehealth program is covered by many U.S. health insurance plans — often at no cost to you. Designed exclusively for women and girls, the program includes a comprehensive initial assessment and ongoing personalized support, all delivered through our secure Telehealth platform. We are in-network with Aetna, UnitedHealthcare, and Medicare. We will be happy to verify your benefits before your initial appointment.
Please note: Lab testing, supplements, and meal plan memberships are not covered by insurance.
Where are you located?
S.T.E.P.S. Nutrition Group is a Telehealth nutrition practice. We provide personalized, evidence-based care to women and girls nationwide — and internationally — through a secure, HIPAA-compliant virtual platform.
I live in a different state. Can we still work together?
We are licensed to practice and bill insurance in most U.S. states. If there are any licensing restrictions in your state, we will let you know prior to your first appointment.
I live outside the United States. Can we still work together?
Yes. While insurance billing, lab testing, and supplement purchases through our online dispensary are available only within the United States, we offer nutrition consulting and educational programs for women and girls internationally.
Do you make meal plans?
For clients in the United States, a personalized meal plan is included with every Mediator Release Test (MRT®) lab order. For U.S. and international clients, we offer a monthly meal plan membership.
How do I work with S.T.E.P.S. Nutrition Group?
We offer four ways to work with us:
1. Clinical Telehealth Services
S.T.E.P.S. to Nourishment™ Telehealth Program:
👉 Start Your S.T.E.P.S. Assessment
2. Become a Meal Plan Member
Structured therapeutic meal plans:
👉 Meal Plan Membership
3. Order Functional Lab Testing (United States only)
Advanced testing and analysis:
👉 Functional Lab Testing
4. Join the 40-Day Cravings Cure™ (Launching Soon)
Our signature educational program based on the S.T.E.P.S. to Nourishment™ framework:
👉 Join the 40-Day Cravings Cure™ Waitlist
What are your fees?
Fees for functional lab testing are itemized individually here. Meal Plan Membership details and pricing are available here. Private consulting fees with Miriam are customized and based on your needs. After completing your intake and insurance verification (if applicable), we will provide a Good Faith Estimate (GFE) outlining the recommended services and associated fees.
Do you provide reduced-fee services?
If there are special circumstances that require reduced-fee or pro bono care, we offer a number of services through the nonprofit arm of our practice. Please fill out an Inquiry Form and let us know your specific needs.
Do you work with other medical providers?
We collaborate with physician partners who are available via Telehealth to provide referrals and prescriptions, when needed. Additionally, we require our private clients to maintain an active relationship with a local primary care provider to oversee routine health monitoring throughout our work together.
What is your perspective on the use of weight-loss medications?
Our perspective is nuanced. In some cases, medication may be appropriate under the supervision of a qualified prescribing provider. However, medication alone is not a long-term solution.
You deserve full informed consent. That means understanding the potential risks and side effects — and having a clear, structured plan in place for when hunger and cravings return, which research suggests commonly occurs around 10 months for many weight-loss medications, including GLP-1 agonists.
At S.T.E.P.S. Nutrition Group, our focus is on correcting the physiological patterns that contribute to weight-loss resistance, whether or not medication is part of the plan. Your plan is tailored to your individual health history, goals, and clinical needs.
What types of payment do you take?
We accept all major international credit cards, Apple Pay, Google Pay, and PayPal. Clients in the United States may also use HSA or FSA funds when applicable. For those who prefer an alternative method, secure international bank transfers are available. Flexible payment plans can be arranged regardless of location, and we work with women and girls worldwide, including the United States, Canada, Europe, the United Kingdom, Israel, Australia, New Zealand, South Africa, and Central and South America.
Do you offer professional-grade supplements?
Through our online dispensary, we provide access to more than 20,000 professional-grade supplements that have been third-party tested and verified. Every product is guaranteed to be authentic and sourced directly from trusted manufacturers — never through resellers. Please note that our dispensary currently ships within the United States only.
Why don’t you offer the HTMA test?
We hear this question a lot. HTMA is everywhere on social media right now, and we understand why it’s tempting. A single test that claims to explain thyroid dysfunction, adrenal burnout, digestive problems, blood sugar issues, and more — for a relatively low cost — sounds like exactly what a lot of people are looking for.
But here’s the problem: the science doesn’t support it. And the people selling it know that — they just aren’t telling you.
The core problem with HTMA is validity. Hair mineral levels do not reliably reflect what is actually happening inside your body. For essential nutrients like magnesium, zinc, calcium, and copper — which are under tight hormonal and renal regulation — hair is not a window into your nutritional or metabolic status. The test is not measuring what it claims to measure. That is not an opinion. That is the conclusion of peer-reviewed science.
A landmark study published in JAMA (Seidel et al., 2001) found no consistent relationship between hair mineral levels and clinical status, and concluded that HTMA results should not be used to guide medical decisions. The Agency for Toxic Substances and Disease Registry (2001) specifically noted that hair levels of essential nutrients do not reflect body stores or functional status. And Ho et al. (2013) sent identical hair samples to multiple laboratories and found significantly different results and conflicting clinical interpretations — meaning the same patient would receive entirely different recommendations depending on which lab processed the sample.
Proponents sometimes argue that inconsistent results are a lab quality problem, not a test problem. That argument doesn’t hold. If a test’s accuracy depends entirely on which lab processes it and how, that is not a defense of the test.
We have seen firsthand how HTMA is being marketed by unlicensed providers — with confident claims about accuracy, personalized insight, and comprehensive health analysis front and center. What is rarely front and center is the fine print: that the service carries no diagnostic responsibility and is offered for educational purposes only.
Interpreting functional lab results and building a therapeutic protocol from them requires a deep working knowledge of physiology, biochemistry, and clinical nutrition. An unlicensed provider recommending a supplement protocol based on a test they are not trained to interpret is guesswork with a price tag — and for patients with real, complex health issues, it can cause genuine harm.
At S.T.E.P.S. Nutrition Group, we use functional testing that measures active biological processes — through validated methodologies including quantitative PCR for GI pathogens and serum, urine, and saliva markers for hormones and nutrients — with established reference ranges and independent peer-reviewed validation. Unlike HTMA, these tests are measuring what they claim to measure.
I heard PCR was unreliable during COVID. Why do you use it for GI testing?
The controversy around COVID PCR testing was not about the technology itself — it was about how results were interpreted and applied at a population level. Cycle threshold values were set in ways that generated significant debate about clinical relevance. That is a policy and interpretation problem, not a technology problem.
Quantitative PCR for GI pathogens is a different application entirely. It identifies specific organisms in the gastrointestinal tract with a sensitivity greater than 94% and specificity greater than 98% against conventional testing methods. The American College of Gastroenterology recognizes molecular testing as superior to conventional methods for diagnosing gastrointestinal illness.
It is a powerful tool that requires clinical expertise to interpret and act on correctly. A positive finding does not automatically mean treatment is warranted. A negative finding does not automatically mean the problem is resolved. Context, symptom history, and clinical judgment determine what happens next — and that is exactly why this kind of testing belongs in the hands of a licensed, qualified provider.
You use evidence-based practice methods, what does this mean?
Evidence-based practice means that every recommendation is grounded in the strongest scientific research available, integrated with clinical evidence and decades of professional experience. Rather than following nutrition trends or applying one-size-fits-all guidelines, we tailor every strategy, tool, and plan to your individual physiology, health history, and goals — because what works is what the evidence actually supports, applied to you!
What is the difference between a licensed dietitian-nutritionist and a nutritionist?
There is a big difference between a licensed dietitian-nutritionist and a nutritionist.
Nutritionist
Anyone can be called a nutritionist. There is no board or governing body that regulates the term. This means your neighbor, personal trainer, or social media influencer with no formal training in nutritional biochemistry can do some research on AI and say they’re a nutritionist. Their advice sounds generic because they lack any foundational scientific knowledge.
Licensed Dietitian-Nutritionist
A licensed dietitian-nutritionist is a credentialed healthcare professional—either a registered dietitian (RD) or a certified nutrition specialist (CNS)—who is qualified to utilize an evidence-based nutritional approach to healthcare.
To become licensed, the CNS credential requires a master’s degree in nutrition science to qualify to sit for the CNS board exam. The RD credential requires a bachelor’s degree in dietetics.
Core academic requirements for both the RD and CNS credential are the same and include food and nutrition science, anatomy and physiology, lifespan nutrition, organic chemistry, nutritional biochemistry, and pathophysiology.
The CNS credential requires additional training in functional lab assessment, nutritional genomics, evidence-based botanical therapies, drug-induced nutrient deficiencies, supplementation, and detoxification.
RD graduates receive additional training in food services management for hospitals and nursing homes, with a focus on USDA Dietary Guidelines such as My Plate and The Food Pyramid.
RD graduates are trained to prescribe specific diets for specific conditions, such as The DASH Diet for hypertension or the Therapeutic Lifestyle Changes (TLC) Diet for lowering cholesterol using a low-fat approach.
CNS graduates are trained to take an individualized approach when addressing complex chronic health conditions—with a focus on the reduction of systemic inflammation and the regulation of immunological response.
All licensed dietitian-nutritionists must complete a nationally recognized internship program. Internships are highly competitive and provide a minimum of 1,000 hours of supervised clinical hours. CNS internships provide experience in functional nutrition with 50-90% of the internship hours in client-based clinical settings. RD internships are primarily in hospital settings.
Upon completion of the internship, the candidate is qualified to sit for the national board exam. Passing the exam earns them the title of either “Registered Dietitian” or “Certified Nutrition Specialist” and the candidate can then apply for licensure on a state-by-state basis.
Why is licensing so important?
Increasingly, we see individuals promoting themselves as nutritionists while having little to no formal training. For example, unscientific modalities such as “applied kinesiology” and “homeopathy” are repeatedly debunked in double-blind, placebo-controlled studies as being no more effective than placebo. Yet, despite overwhelming evidence that these modalities are neither effective nor rational, they persist.
Professional licensing laws help identify who is a qualified practitioner and who is not. Individuals who lack the objective accredited education, clinical experience, examination, and ongoing continuing education demonstrating their competency are not qualified for licensure.
Didn’t see your question?
If you have a question that wasn’t answered here, please fill out an Inquiry Form in our HIPAA-protected private portal and we will do our best to respond within 2-3 business days — usually sooner.