Whether you're ordering in Chinese, going out to a big chain restaurant or grabbing a quick bite at gas station convenience store, ordering after weight loss surgery doesn't have to be challenging if you know what to look for.

How many take-out or restaurant meals do you eat per week? If you are anything like the average American, you're probably eating four or five commercially prepared meals every week from a variety of places. That may sound like a lot but think about it: How many times a week do you stop at Starbucks on your drive in to work, grab lunch at the diner or order Chinese or Italian when you’re too tired to cook dinner? That’s not including special-occasion dinners out or date nights!

And while we are eating more food that’s not made in our own kitchens, we are also eating more calories and bigger portions each time. Studies suggest approximately 100-200 calories more per meal are consumed when we order instead of cook. But so often we’re busy or short on time, and preparing everything from scratch at home just isn’t realistic. The compromise is to find a livable balance by eating out less frequently and making better choices when you do.  Particularly for patients who are preparing for or who have had bariatric surgery such as gastric sleeve,  gastric bypass or gastric band (LAP-BAND), making smarter choices will help ensure daily protein goals are met.  Here are some tips to help when eating out along with the best (and worst) selections from popular cuisines.

• Always choose a balance of protein, fiber and healthy fat that will keep you full and avoid blood sugar highs and lows.
• If nothing on the menu seems right, ask about creating your own dish.  These days many restaurants are used to accommodating individual dietary needs.
• Don't drink your calories.  Low-fat milk or protein shakes are the exception to this rule, but sugary beverages like juice, sports drinks, coffee creations and soda are mostly empty calories and should be avoided.
• Be the first one at the table (or at the office) to order.  We tend to order in a similar fashion to our fellow diners, so going first means you’re more likely to stick with your original, healthy choice.
• The two pillars of healthy eating for weight loss or following bariatric surgery are WHAT and HOW MUCH.  Sometimes a high-protein appetizer or two can make a satisfying meal.  Some restaurants allow post-operative adults to order off the children's menu or will prepare half portions of menu items.
• Plan ahead by checking out menus online.  Even if it’s the day before or still breakfast time, knowing what you’ll have for lunch or dinner helps with planning the rest of your intake accordingly.

Pizzeria/Italian

One of the questions I’m asked frequently is "After surgery, will I ever be able to eat pizza again?"  I usually answer by saying it won’t be every Friday night, but the occasional slice of pizza can fit into a generally healthy post-operative diet. The healthiest traditional pizza choice is 1 or 2 slices of a thin crust pie loaded with veggie toppings. Thrown on some grilled chicken for even more protein and you’ll be able to indulge without derailing your efforts. If you’re eating healthier with a regular-sized stomach, starting the meal with a garden salad can help curb the tendency to reach for a third (or fourth) slice.

If you find yourself choosing from a larger Italian menu, the best choice may be something you create yourself. I’ve found that most restaurants will put any of their entrees or sauces over sautéed spinach or broccoli rabe instead of pasta. Avoid cream sauces or anything fried such as veal/chicken/eggplant parmesan as they tend to be high in calories and fat. Best bets are entrees with grilled or broiled seafood, chicken or shrimp, fra diavlo, cioppino, red clam sauce and tomato-based sauces with veggies and some type of meat or seafood. If you simply can’t resist the pasta, ask for a small side order and eat it last. Better yet, ask someone at your table for a bite or two and you won’t be as tempted to overdo it.

Fast food restaurants

Depending on the particular chain, choices here can vary widely. Best bets are salads with grilled (not fried) chicken and a half portion of low-fat or “lite” dressing as well as grilled chicken or fish sandwiches eaten open-faced or with no bun. A plain hamburger or cheeseburger (no sauce or mayo) piled with lettuce, tomato and onion is always an option. Lose the bun and you’ll cut out about 200 calories of empty carbohydrates. In general, it’s best to avoid anything crispy or fried, special sauces such as bbq and honey mustard, mayonnaise and some salad dressings.

Mexican/Latin/Southwest

This type of cuisine can be challenging but also offers a number of healthy options. The key is to forgo most of the starchy, high-carb sides in favor of lean protein and vegetables. Fajita platters minus the tortillas and rice are flavorful and filling. Start with any of the lean protein options usually available such as shrimp, salmon, chicken breast, pork loin or flank steak. Ask for a side of shredded lettuce instead of rice and pile on the fajita veggies. A small serving of beans provides slow-burning carbs and bulks up the fiber.  Build-your-own salads are also a great choice so you can control what goes on your plate. Start with a bed of lettuce then add a protein like chicken or pork, and top with pico de gallo, beans and only a small amount of olives, shredded cheese or guacamole.

Casual dining/Quick service restaurants

Large menus can be even the most conscious eater’s undoing, but with seemingly endless choices also comes some healthy ones.  You just have to know what to look for.  As always, salads with some type of protein can be a good choice.  Just be sure to use no more than 2 tablespoons of a low-sugar/lite/low-fat dressing and keep portions of high-calorie toppings like cheese, nuts, seeds and avocado small.  Breakfast for dinner – aka an omelet with veggies and maybe a little cheese – is always a great choice.  Skip the home fries and toast and opt for a small side of fruit or turkey bacon instead.  Other high-protein choices include baked or broiled seafood or chicken with a side of veggies, broth-based or bean soup, chili, or ½ of a wrap filled with lean protein and veggies.  Another good rule of thumb, always ask for sauces or gravies to be served on the side or left off your dish completely.

RELATED: EAT THIS, NOT THAT FAST FOOD EDITION

Thai and Chinese

When it comes to Thai or Chinese cuisine, it’s as easy to make a super-healthy choice as an unhealthy one. There are many fat, carb and calorie bombs here so knowing what menu items to ignore is important. Steer clear of noodle dishes like pad thai, dumplings and lo mein. Ditto for battered and fried meat or seafood like General Tsao’s chicken or Sweet and Sour Pork. Abstain from fried rice, egg rolls, spring rolls, tempura anything, and menu items described as “crunchy” or “crispy” that are most likely fried in oil.

So what can you eat? While an order of steamed chicken and vegetables is always a guaranteed healthy option, it may not always be the most appealing choice. Choices that will please your palate and still keep you on track include seafood or hot and sour soup, grilled chicken or shrimp skewers, Thai summer rolls, and chicken lettuce wraps.  Sometimes one or two appetizers can make a meal, but if you’re looking for an entrée, stick with any stir-fried (not deep-fried) protein and vegetables. Think beef with broccoli, shrimp with mixed veggies, or tofu and eggplant. White sauces may be lighter in oil than brown, but always ask about the preparation to be sure.

Japanese

While there are many similarities between Japanese food and other types of Asian cuisine, the predominance of noodles and sushi on the menu necessitates some additional ordering know-how.  One tip to incorporate no matter what you order is to eat with chopsticks.  They’re likely to slow down the pace of eating which can result in fewer calories overall.

Best bets for appetizers include a green salad with avocado or seaweed salad with sashimi, edamame (green soybeans), seared tuna, and miso soup.  If sushi is your thing, ask for rolls to be made without rice or order sashimi with a small traditional roll.  Avoid ingredients like crunch, tempura, sweet sauce, and mayonnaise to keep sugar and fat calories in check.  And ask about the ingredients in any spicy or special sauces if you’re unsure. Also, beware of noodle dishes like udon and soba which are typically high in carbohydrates due to the large portion size.  Stick with entrees like teriyaki chicken, shrimp, or tofu with veggies which are all good choices as long as you leave off the side of rice.  And don’t be lured into thinking brown rice is so much better than white.  While it may have slightly more fiber, total carbohydrates and calories are basically the same.

Indian

Depending on where you live, flavorful Indian food can be quite accessible these days. But if you’re not careful, it’s all too easy to fall for a dish loaded with calories. Ordering off a menu that describes a dish’s ingredients will help you make better choices. If, however, you’re eating at a buffet, here are some tips for navigating this cuisine.

As with any type of food, avoid anything covered in batter or dough and deep-fried. Skip over the samosas and padoka, which are high in carbohydrate and fat calories.Paneer, a full-fat cheese common in many vegetarian dishes and sauces, can be a good source of protein, but should be eaten in moderation due to the potential for high calories. Stick with a half-cup portion and pair with veggies and other lower-calorie fare.

When it comes to sauces and breads, clarified butter or "ghee" as it’s known, is a common ingredient. Avoid ghee-based sauces, such as butter chicken or dum aloo, as well as malai, a heavy cream used in many sweet and savory dishes.It’s also best to skip the naan, a traditional Indian bread made of refined flour and brushed with ghee for added flavor.

Since the spices in Indian cooking are intensely flavorful on their own, asking if a dish can be made ‘"lighter" using coconut milk or broth means you can still enjoy a delicious meal without all the added calories from fat. Better choices include anything with veggies and lean meats or seafood, such as prawn, chicken or lamb kabobs. Yellow lentils prepared with less fat and a side of paneer are also good choices if you’re looking for a higher-protein vegetarian option. Tandoori dishes, prepared by marinating fish or meat in yogurt and spices then cooking in a clay tandoor, are typically loaded with flavor without excess fat.

Pair with a side of veggies and you’ve got a super healthy and delicious option. Passing on the rice and breads will help avoid unnecessary carbs while keeping protein front and center. Finish your meal with a delicious cup of tea instead of a sugary dessert to end your night out on a healthy note.

BBQ /Chicken restaurants

The trick to navigating these places is to avoid high fat meats, all things deep-fried and high-carb or high-calorie sides.  If grilled chicken pieces are an option go for those.  If not, choose one or two pieces of fried chicken with the skin removed.  If ribs are your thing, they’re a good source of protein but are usually higher in fat and calories.  Boiling them first cooks off a lot of the fat, so ask your server what the leanest choice is they offer.  When it comes to seasoning, a dry-rub will usually have less sugar and calories than liquid barbecue sauce.  Choose a side dish carefully and opt for non-starchy veggies like a side salad, grilled asparagus or mushrooms, or green beans.  A small order of coleslaw or ½ ear of corn would be the next best choices.

Convenience stores and rest stops

Depending on where you are geographically speaking, there can be a lot of variation here.  Some locations may have a deli where you can get some turkey breast or lean ham with low fat cheese.  If pre-made sandwiches are your only choice, lose the bread and eat the insides with some brown or yellow mustard for dipping.  Check the refrigerated section for hardboiled eggs, a Greek yogurt, part-skim cheese sticks, or a single-serve, low-fat milk.  For the best non-perishable choices, check the aisles for small bags of roasted nuts or seeds, trail mix or protein bars.  Just be sure to check the nutrition facts label for grams of sugar when choosing yogurts, bars or trail mix and always go with the lowest option.

Coffee shops

If your favorite thing to order here requires that you say “light and sweet” or any word ending in –atta or –cino, I’m afraid you’re about to be disappointed.  All of these specialty drinks are liquid calorie bombs and have no place in a healthy post-weight-loss-surgery diet.  Even the light, skinny or low-fat versions should still be avoided since drinking calories is a big no-no.  And forget the baked goods altogether since there’s no such thing as low-carb, high-protein doughnut as far as I know.  The good news is you don’t have to forgo your caffeine fix altogether, you just have to change what you order.  Better beverage choices include an unsweetened latte made with low-fat milk or plain hot or iced coffee and tea.  Try adding milk and your favorite no-calorie sweeteners or flavors like cinnamon, lemon and vanilla until you come up with your new go-to favorite.  If you’re in need of breakfast or a snack, look for yogurt, egg sandwiches on thin bread or wraps, roasted nuts and protein snack packs.

Vending machines

We’ve all been there, you’re stuck somewhere, haven’t eaten for hours, and the only thing available to snack on requires you to hit “E-9.”  Healthier choices here are probably the most limited, at least as far as traditional vending options go, but don’t despair.  You can usually find roasted nuts, sunflower seeds or a bag of white cheddar popcorn in most places.  The small portion size and combination of fiber, protein and fat will hopefully keep you just full enough to make it out of wherever you are in time for a healthy, protein-based meal.

Armed with some knowledge and tips, you can navigate any menu like a weight loss surgery pro.  Happy ordering!

References

1. Mendez, E. Adults take in 200 more calories per day when they eat out. http://www.cancer.org/research/acsresearchupdates/cancerprevention/adults-take-in-about-200-extra-calories-per-day-when-they-eat-out Published August 15, 2014. Accessed August 7, 2015.
2. Hamm, T. Don’t eat out as often. http://www.thesimpledollar.com/dont-eat-out-as-often-188365/ Published July 31, 2014. Accessed August 7, 2015.
3. The State of Obesity. Fast facts: Americans’ eating habits. http://stateofobesity.org/facts-trends-in-americans-eating-habits/ Accessed August 7, 2015.