Dr. Angela & Cecilia Dinora: Welcome to the Lifestyle MD podcast, the show dedicated to busy adults navigating family, career, and the challenges of midlife while striving for lasting wellness. I’m Dr. Angela, and I’m honored to be your guide on this journey.
Dr. Angela: Hi, this is Dr. Angela. Welcome to another episode of the Lifestyle MD. I have Cecilia here from Terra Health Coaching, and she is a phenomenal human being, to say the least. We had a chance to connect at the Hint Summit, and I’m really looking forward to collaborating together. So please tell our listeners a little bit more about you — who you are, why you do what you do, and who you help.
Cecilia Dinora: Thank you so much, I’m so happy to be having this conversation with you. I am lifestyle medicine certified as a health coach. I started my training five years ago. I’ve done a couple of different certifications, but I’m really passionate about small action steps that help patients see long-term change. I started with public health, studied nutrition, then got certified as a whole food plant-based health coach. I’ve applied that to my own life since I was 21.
I come from a family of diabetics — my family immigrated from Latin America to California when they were quite young, and I started to observe a lot of issues with their health, mental health, and weight from a young age. That created a lot of curiosity, and it drove me to figure out what works despite your environment. Having lived abroad, I got to observe how Brazilians live, how Swiss people live, and now I live in Spain, where the lifestyle is very different from the United States — walking everywhere, biking, slow eating, sitting down and enjoying meals instead of eating in front of a computer stressed out between meetings.
Dr. Angela: I really need to work on that still.
Cecilia Dinora: Trust me, I’m still working on it too — we’re all a work in progress. My passion has always been working with people. Seeing patients improve as a coach is one of the most satisfying things I’ve ever done. When someone comes back after three months and says they have more confidence — that it wasn’t just the number on the scale, but that they felt internally so much better, their energy, their focus, their capacity to show up for the people they love — that’s what this is all about. It’s about internal transformation, which allows people to be so much more authentic.
Dr. Angela: How did Terra Health Coaching come about? How long has it been around, and how did it get its start?
Cecilia Dinora: My business partner, John Deezer, based on the East Coast, started it pre-pandemic working with employers in person. After the pandemic, everything moved online — which is great, because now all of our coaches, based across the US, can connect with patients no matter what time zone they’re in. I had just moved to Spain to do my MBA and had actually written a project proposing exactly this concept. After I submitted it, John found me on LinkedIn, interviewed me, and it turned out this already existed. I started working closer with the team, and now I’m the COO — I’m the first point of contact with patients, I work with physicians to keep them updated on their patients’ progress, and I’m now moving into the employer space as well. Terra works with DPC docs, concierge medicine physicians, and now employers who want to provide health coaching for their teams — which is revolutionary.
Dr. Angela: That’s fantastic. The employer space feels like the next phase for DPC and concierge, membership-based models — health costs have gone up so much, and patients and employers alike are getting more aware of where their spend is going.
Cecilia Dinora: It’s all about ROI in the employer space. Our GLP-1 support program for employers is a year-long program broken into three phases. It sounds intimidating, but with weekly and biweekly sessions, the year goes by fast. In the first month, we don’t allow access to the medication — patients apply for eligibility after their first four coaching sessions, so they can dip their toe in first. We’ve had 22% of enrolled employees not get on a GLP-1 at all, because after four sessions they were already building momentum. The cost savings there are in the thousands. Some do eventually get on the medication but never ramp up to the highest dose because they’re already making lifestyle changes — building an exercise routine for the first time in ten years, focusing on high-fiber foods, hydration, protein, and protecting their muscle mass for metabolic protection.
Dr. Angela: That’s amazing — I’m floored.
Cecilia Dinora: We were floored too! Another patient who enrolled in the GLP-1 program actually moved into our general lifestyle medicine program because they chose not to use a GLP-1 at all. And to be clear — GLP-1s work incredibly well for the patients who need them. But so many are able to avoid ramping up because they’re working with a coach on lifestyle change.
Dr. Angela: Everything you’re describing matters so much to my practice — chronic disease, autoimmune conditions, and gut health are huge issues in primary care. I have an InBody scanner in my clinic for body composition, and I don’t do an annual visit without it. I had a patient recently with a normal BMI of 23, but her body fat percentage was way above average and her muscle mass way below average — one of the most concerning compositions I’ve seen. She’s about to turn 65, and that’s a real fall-risk and metabolic concern. I’m connecting her with you.
Cecilia Dinora: Knowledge does not equal habit change — knowledge does not equal action. That’s why accountability matters, and why seeing the numbers from something like an InBody scan is so powerful — it brings the future into focus. Women especially face pressure to be small, but real longevity comes from strength and muscle. It’s never too late to make changes, even small ones.
Dr. Angela: The patients in my practice who’ve had the most transformation this year have mostly been in their 60s and older. People seek care when they have a need, and once we start talking — really listening to what’s keeping them up at night, what’s weighing on them — there are so many “aha” moments.
Cecilia Dinora: People need support; we’re not meant to do this alone. Through consistent contact, people realize they’re not broken — they’ve just been through a lot and didn’t have the guidance to get through tough situations. It’s about helping people move out of survival mode, which I think half of America is in right now.
Dr. Angela: Let’s cover what lifestyle medicine actually is, and what its pillars are.
Cecilia Dinora: Lifestyle medicine is an evidence-based medical specialty using therapeutic lifestyle interventions — going back to basics. The pillars are: whole food, predominantly plant-based nutrition (not vegan, just plant-forward); physical activity — any consistent movement like gardening or walking, not just the gym; restorative sleep; stress management; positive social connection; and avoidance of risky substances.
Dr. Angela: I like to add an honorary pillar: time in nature.
Cecilia Dinora: Yes, 100%. Just being around green space changes something neurologically and physiologically. It really should be an official pillar.
Dr. Angela: There was a recent study — I think out of Japan — on the hormonal and psychological benefits of forest bathing.
Cecilia Dinora: People think it sounds hippy-dippy, but it’s real science — they can measure actual metabolic markers. I have a small forest park near me in Spain called a “bosque.” I have a dog I hike with every morning, and when I was going through my divorce, that morning walk in nature was the thing that got me through it. There was so much calm, so much dopamine, so much healing — even just walking in silence with my dog. I didn’t understand the science behind it until much later.
Dr. Angela: That’s so calming just hearing about it — I’m going to go for a walk after this call.
Cecilia Dinora: Do it! It’s a holiday, treat yourself.
Dr. Angela: Let’s talk about Terra’s programs. If someone is referred by a physician, are lifestyle coaching, chronic disease management support, and the GLP-1 support program the three main categories?
Cecilia Dinora: Yes, those are the three main categories, and we’ve just added a specialty autoimmune protocol led by a coach named Lisa, who’s incredible — especially relevant given how many employees in our employer contracts deal with autoimmune conditions. We also have a PharmD, Judy Waldman, who specializes in the gut microbiome, plus two dietitians who can be looped in as consults at any point.
Dr. Angela: I could literally cry — this is the kind of support I’ve always wished I could offer my patients. You have the solution.
Cecilia Dinora: We’re an extension of you. We help implement the protocols for what’s happening in patients’ day-to-day lives outside the office visit. As trust builds with their coach, patients open up more, creating a full support network that complements your practice. On the process side: as a physician, you fax a referral from your EMR, I reach out to schedule a no-commitment “breakthrough call,” and from there I pair the patient with a coach. Physicians get a monthly summary from the coach so you always know what your patient is working on.
The general lifestyle medicine program is three months, 12 sessions — a half hour with your coach once a week — and it can address anything: weight loss, stress management, sleep. We also have three personal trainers, including Tammy, who specializes in things like pain management and GLP-1-related weight loss support, for patients who want a stronger exercise focus.
Dr. Angela: So those categories help clarify the right fit before people get further guided into their specific path. Can people self-refer without a physician?
Cecilia Dinora: Yes, anyone can join — you don’t need a physician referral, though we typically work with physicians because of the added value on both sides. We also offer eight languages, and importantly, we’re not AI bots.
Dr. Angela: I didn’t realize that.
Cecilia Dinora: We’re human-first, technology-supported. You’ll always have a live coach, never an AI. We use Practice Better, a HIPAA-compliant platform where coaches hold sessions and patients can message their coach anytime between sessions if they’re struggling.
Dr. Angela: That’s amazing — and the employer connection is exciting too. There’s a group of us in West Michigan building a collective of DPC practices to help support employer populations, so this could be a great fit.
Cecilia Dinora: It’s a great way to scale — employers get the benefit of a DPC relationship, and the DPC gets full coaching support. It’s protection all around, and it translates into real cost savings.
Dr. Angela: And better quality of life and satisfaction for patients.
Cecilia Dinora: The stories I could tell you — we’d be here for ten hours. I’ve cried more than once seeing how much someone has accomplished.
Dr. Angela: Same — this isn’t just a job for either of us. We’re genuinely invested in outcomes. Your “why” isn’t so different from mine — family history of diabetes and cardiovascular disease, and wanting to help others avoid that same path.
Cecilia Dinora: That’s why it was an instant connection — because the future is working together. Patients need more than a 15-minute appointment, and I think about people who don’t even have access to a DPC like you.
Dr. Angela: My heart breaks for them — it’s not enough, and it’s not their fault. We haven’t been taught these things in school — not how to eat well, manage emotions, or deal with trauma.
Cecilia Dinora: Even physicians aren’t inherently taught lifestyle medicine as a foundation. No matter what area you practice in, we can all agree: Americans need more fiber, more sleep, less stress, more time in nature, and more community.
Dr. Angela: It’s really just common sense, backed by decades of evidence — look at the Blue Zones. These simple, proven approaches are the path to a better quality of life and longevity.
Dr. Angela: So how can people connect with you and learn more about Terra Health?
Cecilia Dinora: You can find us at terrahealthcoaching.com, and we have a YouTube channel with years of patient testimonials. You can also email me directly at cecilia@terrahealthcoaching.com for a complimentary call to ask about your health concerns, our support, and financing.
We’re $285 a month and HSA/FSA eligible. We’re not yet approved by insurance, though that may be changing soon. All of our entry-point programs are three months, 12 sessions minimum, since it takes at least 90 days to start seeing real shifts. Some patients who finish our year-long GLP-1 program actually continue with maintenance coaching afterward — just one session a month — because they don’t want to give up that connection.
We also offer chronic care management for physicians billing insurance: six sessions over 12 weeks, every other week, using the same program types (GLP-1 support, lifestyle medicine, etc.) — the patient doesn’t pay, since we provide the CPT codes for billing.
Dr. Angela: That’s a great option for people in the system who understand the value of lifestyle medicine but don’t have the time to implement it themselves.
Cecilia Dinora: It works well for hospital physicians and hybrid DPC models too.
Dr. Angela: Cecilia, I am so grateful for this conversation. I also saw the pop-up about your retreat — I need to go to that!
Cecilia Dinora: That’s my brainchild! My friend and I met almost ten years ago working in international education in Brazil. She’s Italian, and her family bought a villa in Verona — when she saw what I was doing with Terra, she asked if we could create health and wellness retreats together. We now run lifestyle medicine retreats at this beautiful villa in the vineyards outside Verona, one of the most romantic areas of Italy. It’s all lifestyle medicine applied to Italian culture — whole food plant-based local cuisine, bike rides through the vineyards, and a trip to Lago di Garda, the largest lake in Italy, for walking meditations and journaling. My colleague Simon Matthews, who’s also in the lifestyle medicine world, co-leads it and runs deep relaxation sessions.
Dr. Angela: That sounds fantastic.
Cecilia Dinora: You should come!
Dr. Angela: I’m serious too. This is wonderful, Cecilia. Will I see you at ACLM in November?
Cecilia Dinora: I’m flying back just for that.
Dr. Angela: Not this year for me, but maybe the following year — I try to go at least every other year.
Cecilia Dinora: Definitely. Well, thank you so much, I really appreciate your time.
Dr. Angela: You take care.
Cecilia Dinora: Good to see you — we’ll talk soon.
Dr. Angela: Bye bye.
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Outro: This has been another episode of the Lifestyle MD. Special thank you to Lou Moussa for the show theme music, created with Brie Photography and makeup by Janae for the cover photo. If you enjoyed this podcast, please subscribe and share with another woman doctor who may benefit. You can follow me on Instagram at @angellalifestylemd. I am Dr. Angela — thank you for joining me today.
