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Think about those gaps. Experiment to see if there are opportunities to increase the
amount you already experience or to create joy at different times and how that makes
your body and being feel. More than what? How much is more? If you don’t know, your
first step is to quantify your current joy, noting when and for how long you currently
experience joy. That’s the general, across-time part of the experiment.
Now, over the next few days:
Identify joy cues: Take a moment to define how you will know you are
experiencing joy. We call these “joy cues,” and you will use these to mark the start
and end of your joy. (Examples: when I laugh, when I feel fully present, when I
start with a positive thought or attitude versus a negative or judgmental one . . .)
Track it: Over these few days, note when you find yourself experiencing joy—the
starting and ending points. (Example: 6 p.m. to 8 p.m.; that two-hour dinner with
friends.)
Observe joy triggers: What sparked your moments of joy? (Examples: being in
the company of friends, yoga, taking a walk with your dog, meditation, laughter,
waking up.)
Note joy interruptions: Identify what suppressed, delayed, or outright destroyed
your joy. (Examples: a friend commenting on your weight, seeing an email
notification, seeing something irritating or upsetting on TikTok.)
Evaluate your results:
Balance I: Is the amount of time you are experiencing joy greater than the amount
of time you are not? If no, this would be a better goal to work toward for most
days.
Balance II: Are there times of the day or days in the week that are joyless or when
joy is less frequent? If yes, explore what could help you invite joy into these
moments some of the time.
Quality I: Look at what ignites or excites or stimulates your joy. Are these
outward sources where your joy comes from or are they catalysts to joy that’s
inside you? Maybe that joy is tap-into-able with outer catalysts, or even without
them?
Quality II: Look at what triggers tend to move you from joyful to fearful or
otherwise disrupt your joy. For each of these, think of ways that you could hold on
to your joy for longer, reducing or removing the impact and frequency of these
triggers.
What Is a Better Quantity of Joy?
As far as I know, no one has invented a joy meter with a set of metrics. And I’m good
with that. Another gadget we can do without. We all are pretty skilled at keeping track
of our joy to the extent that serves us. We know when we have more and when we have
less. We can track our joy directionally without measuring it in units. We’re also good at
feeling different kinds of joy—different types and qualities.
Recognizing different kinds of joy and then recognizing the kinds that speak to you is
a fulcrum for upping your joy quantities.
Use inspiration, on repeat: My friend’s dad loved telling me about his morning
routine. On waking, he went downstairs and watched the last five minutes of the
movie Rudy, which brought him pure joy. I witnessed it more than once—it was
awesome! The “what” here is personal, but the focus on repeat for inspiration is
the key. The “it” could be a letter from a friend, a poem, a quote you get as a tattoo
or a screensaver.
Spend time with animals: Dog owners report higher levels of joy. Dogs and other
animals provide companionship, unconditional love, and a sense of purpose, all of
which can contribute to experiencing joy. Plus, the simple act of petting or playing
with your animals can release feel-good hormones such as oxytocin and serotonin.
One of my patients tells me about a photo of her dog that she uses as a calm point
in tense work moments and online meetings.
Get fresh air: Getting out into nature can increase the production of endorphins,
neurotransmitters, and a protein called brain-derived neurotrophic factor (BDNF)
that helps brain growth, repair, and development. Taking a few moments to
appreciate the beauty of nature can bring better health to you mentally and
physically.
Get a visual cue from art or a cute picture when you are using your digital
devices to invite joy. A client used AI to create an image that is her computer
wallpaper and invites joy for her.
Set boundaries and say no (joyfully). Opting out of activities or making choices
to prioritize yourself can increase joy. Conversely, choosing to spend time
connecting with someone or a set of people with whom you experience joy, by
saying no to other commitments, can also be a way to improve your quantity of joy.
Not compromising your needs is a strong strategic move to increase the amount of
joy in your life. Note: This requires a step beyond saying no; you need to mean it.
Saying no with conviction—truly choosing to miss out—is a way to experience
joy: From FOMO, the fear of missing out, to JOMO, the joy of missing out, we like
to say. If you say no and don’t mean it—for example, you choose to stay home but
then watch the “activity” via social media or texting with someone there, and
question your choice—that doesn’t invite more joy.
MELTING THE CHEESE
These lifestyle components—the cheese—as variable as they are, have in common
being either Switch-engaging or Switch-enhancing. Many are both. This last section may
feel like an overwhelming fondue of musts, shoulds, and not-doables. If so, stop. We
can’t have our cheese give us elevated stress. Recall that cheese can be a dusting, an
accessory, a lot or a little, or a snowfall. But what it should always be is delicious for
you. Use the table below to get a look at the overall recommendations, and the
upcoming assessment will help you determine with which and how much you might
experiment to add your cheese.
YOUR LIFESTYLE RECOMMENDATIONS (DAILY)
QUANTITY
Activity and recovery daily guidelines:
Focused exercise: >30 minutes most days; alternate types (see balance) and
duration (see timing)
Stretching: >15 minutes most days; alternate types (see balance)
Movement: every 180 minutes for at least 5 minutes
Sleep: >7 hours
Playtime: >1 hour
Screen time: <6 hours*
Unlimited (but at least 30 minutes) laughter, time in nature, pauses,
pets/touching, hugs, joy, and alone time
*All screens combined.
BALANCE
Aim for diversity in the sources for each of the above (strength vs. cardio,
higher vs. lower intensity, upper vs. lower vs. whole-body movements, types
of sleep [REM, deep, etc.], recovery work, types of stretching [work out your
fascia, etc.]).
Choose exercise that challenges your body—it should feel uncomfortable or
“hard”—at least twice weekly. Hard and uncomfortable does not mean
painful. Get insights from someone who evaluates your body, especially if you
have a current or past history of injury.
Add different types of breathing, especially to remedy elevated stress.
Balance time with others and time alone.
TIMING
Plan pit stops for movement and mindset shifts about every 3 hours.
Establish and try to maintain a consistent sleep window.
Be in bed, attempting to sleep by 10 p.m.*
Sleep and wake at the same time, weekday or weekend.
Limit all screen time to begin at least an hour after waking and finish an hour
before bed.
Experiment with adding joy where it is not present
*Or choose 1 hour earlier than you currently are getting into bed to fall asleep.
YOUR LIFESTYLE RECOMMENDATIONS (DAILY)
QUALITY
Stop caloric intake (that includes alcohol) 3 hours (at least) before bed.
Create a cold, dark room for sleep.
Experiment with breathing through your nose and with longer exhales than
inhales.
Attempt to reduce activities and thoughts that elevate stress (especially about
things over which you have no or minimal control).
Move your body in different ways.
Avoid movements that create pain and repetition of the exact same movement
types.
Choose playtime activities that generate joy, happiness, soul-singing.
Part IV
How’s Your Switch Function?
But, Ashley, what’s better for me? Recall how we started the pizza-building process
with the description and delivery of a tool—the “Better Be Delicious to Me Right
Now” test. It’s time to apply that test to the pizza you’ve been building, because to be
better for you, it has to be delicious to you right now—a metaphor here for matching
what your body needs right now.
The flavors, textures, and aromas of a pizza that hits the spot are the result of finding
the right ingredients, assembling them in the right order, firing at the right temperature,
and serving the pizza to a body that wants exactly that version of the recipe. So far, we
have the ingredients and the order, but for toppings and baking temperature, we need
some critical information on how your Switch is functioning and what that means for
your ecosystem. Let’s (finally!) move on to the Switch-Function Assessment to map
your Switch-function status, and then use that data to identify your better choices for
optimization.
The Switch-Function Assessment happens in two phases:
Phase 1: Is yours optimal or suboptimal?
Phase 2: If suboptimal, is it suppressed, delayed, or dysfunctional?
To optimize your Switch function, you need to find out where your Switch stands
right now.
That’s what this—the first-ever Switch-Function Assessment—enables you to do.
This assessment uses a combination of tools: clinically validated, quantitative ones; and
subjective, experiential ones. The assessment, as a resource that hasn’t existed before,
is evolving. My patients have contributed to it significantly, and I’ve now formulated it
so that you can do it on your own.
Beyond establishing whether your Switch function is suboptimal, this assessment
has four main objectives:
1. Establish benchmarks as starting points to enable you to see more clearly what
happens when you implement new choices. You’re looking for directional
improvement, meaning improvement relative to your starting point. Such starting
points have a way of motivating us. When it feels like we’re not making progress,
or at least not noticeable progress, a look back to where we’ve come from usually
tells us that we are.
2. Combine a set of widely different parameters to inform your picture of where your
Switch is, optimal or not; and if suboptimal, where it is on the continuum right
now.
3. “Gaming” the mission to optimize and restore delivers a strong productive benefit.
It’s often helpful to get competitive—with ourselves.
4. Last but far from least: As you probably don’t need to be told, the interactions that
drive our weight-health ecosystem are complex. So engage the assessment not just
for a thumbs-up or thumbs-down on the question of Switch-function status. The
assessment is a mini-mission. It’s the reconnaissance in which you do a lot of
initial fact-finding and intelligence-gathering to get more specific and granular in
personalizing your mission to optimize and restore weight-health hormone and
ecosystem function.
We’re going to do some GPS-type work and locate your Switch initially on this
continuum:
SUBOPTIMAL → OPTIMAL
If your Switch function is not full-on optimal, we’ll go to the next level.
To what degree and in what way is your Switch suboptimal? We get more specific
on the suboptimal end of that spectrum:
DYSFUNCTIONAL → DELAYED → SUPPRESSED
Mission success is moving your Switch from where it is toward optimal function.
That can occur in leaps from dysfunctional to optimal. More often it moves along the
continuum as your choices initiate Switch-function improvements.
GPS ALERT
YES, THE ASSESSMENT IS NOT NEUTRAL
The Switch-Function Assessment is not geared toward confirming that Switch function is optimal.
It exists to help people zero in on their degree of suboptimal Switch function and make it their mission to
address.
I can count on a hand and a half the number of patients who’ve come to me with optimal Switches. After all,
the data show that 93 percent of Americans are metabolically unhealthy.
The vast majority of our Switches—nearly all of them—are struggling to keep up. And everybody’s Switch
at some point will experience challenges. Modern living ensures that.
The Switch-Function Assessment rolls in these stages: (1) gather and collect, (2)
the Switch-Function Quiz, and (3) process your results.
Chapter 9
The Switch-Function Assessment
AN OVERVIEW
The Switch-Function Assessment is not a one and done. You are doing it first to find out
where you are. Then you will reassess after about thirty days and continue to optimize.
You will keep reassessing because Switch function for optimal weight health is a
dynamic, lifelong process. So, you need a place to easily access your current and past
data for comparison. To complete the assessment, choose whatever feels easiest and
most reliable for you, personally. You have two options. You can complete the
assessment online or you can use a notebook or a digital note-taking tool to complete
this assessment. You will receive an email with your answers and details about how to
process your results. To access the assessment online, follow the QR code that follows.
Stage 1: Gather and Collect
Gather: This pulls in data you’ve likely already got.
Collect: This pulls in data that you can easily obtain on your own or maybe with a
bit of help. As you read through, you will see that all of this can be done on your
own, but some of it may feel easier with someone to help you.
TIME COMMITMENT: It will depend on what data you have and how easily
accessible your data is, but in general it takes about thirty minutes to an hour on one day,
plus a few minutes daily over the course of a week. It’s useful to first read through to get
a timetable together. If you decide to enlist a person to help, get on their schedule.
Stage 2: Take the Switch-Function Quiz
With your gathered and collected data in hand, take the quiz.
TIME COMMITMENT: One block of about five minutes the day of your choosing,
as long as you have all of your data in hand.
Stage 3: Process Your Results
Follow the instructions to interpret your quiz answers and learn your Switch function’s
current status: optimal or suboptimal; if suboptimal, then dysfunctional, delayed, or
suppressed.
TIME COMMITMENT: Thirty minutes.
Let’s get doing . . .
SWITCH-FUNCTION ASSESSMENT, STAGE 1: GATHER AND COLLECT
Gather Data
Earlier—for the crust—you did the first part of your digestive assessment and the
hydration experiment. Gather that data now, if it is not already where you are collecting
your Switch Optimization data.
Your next step is to gather additional data—current labs—as instructed below.
These labs are important to the assessment and everything going forward in your
personalization. I suggest focusing on them first, so you have a plan to have them in hand
when you get to the quiz.
Instructions for lab data:
Recent: You want close-to-current lab data, from within the past six months. If
you’ve had lab work done in the past six months, have a look at the results. Some
or all of these tests are likely there.
For any you do not have currently, you may be able to get all or some (especially
the core labs) done via your practitioner and insurance; you may also choose to
invest in getting some or all of them on your own; the online resources will guide
you to options.
Core labs: hsCRP, hbA1C (also known as A1C), low-density lipoproteins (LDL),
triglycerides (TGs), vitamin D 25 OH
Additional labs: fasting insulin (not the same as fasting glucose), uric acid,
glycated serum protein, apolipoprotein B (ApoB), aspartate aminotransferase
(AST), alanine aminotransferase (ALT)
Optional: a wearable continuous glucose monitor (CGM) sensor to evaluate
blood sugar activity in response to your choices. If you use a CGM, gather the
most recent data (this past week or month, for example) for time in range (for
persons who are not diabetic, use 70–120 as your range; for diabetics, use 70–
150 as your range), average glucose, and number of spikes and dips. Note this
data for use in the upcoming quiz.
That’s the lab data.
Collect Data
Body Composition Data Collection
Like your digestion and hydration, these data are key performance indicators of weight-
health-ecosystem function. You’ve unlearned valuing the total number on the scale. What
we are now collecting—your fat mass (the types and locations), skeletal muscle mass,
and bone mass—helps you take your best shot and hit the bull’s-eye as you personalize
your optimization.
There are two ways to collect this data—by machine or by hand. The machine will
give you location and type specific data in pounds (or kilos) and percentages. (Those
done by hand, waist circumference—in the old days, “waistline”—or waist-to-hip
ratio, will not. The latter give you only an approximation of your current body
composition. However, that data is sufficient for our assessment purposes.)
Do these ideally on waking, after a bowel movement and/or urinating but before
eating or doing any exercise.
Choose a day after a night that was as close to normal for you as possible. (For
those menstruating, better to check on days 5–15 of your cycle.)
By machine: Collect the data from the last ninety days via a DEXA scan, a bioelectrical
impedance analysis (BIA) measuring scale, or from an app that does a visual body scan.
While you may want to track ongoing progress in pounds or kilos (of body fat and
skeletal muscle mass change), for the quiz, collect body fat percentage and skeletal
muscle mass or lean (fat-free) body mass depending on what is provided. Also collect
visceral fat mass, if available. There is no “best” scale for this despite the marketing
claims. Ideally the one you use now will be accessible for future assessment.