Eating From the Kid’s Menu After Bariatric Surgery: Just Say NO!February 7, 2018
Bariatric surgery describes a variety of surgeries performed on parts of the GI tract to help decrease the obesity epidemic. The main purpose of these procedures is to restrict the amount of food that can be consumed ultimately helping to curb appetite quicker and help the patient lose weight.
Almost all bariatric patients work with a Registered Dietitian to ensure that they are adequately nourished both pre and post-operatively. Although it can be very challenging, it is critical for patients to get a variety of nutrients to promote a healthy lifestyle. Unfortunately, due to restriction, many patients opt for smaller more manageable meals.
Quantity over quality is not always the best choice.
What Does the Bariatric Patient Need?
Bariatric patients need to focus on building their meals around protein. Protein can help our bodies feel fuller for longer as well as heal any surgical wounds, and build lean muscle mass. Many high protein foods include meat, poultry, fish, and some dairy. Following protein, bariatric patients should aim for a variety of different colored fruits and vegetables in order to ensure consumption of vitamins and minerals or micronutrients, that will help to perform everyday functions in the body. Lastly, bariatric patients should aim to include a few servings of healthy fat during the day, such as oils, nuts, and seeds, and avocado to help build a strong immune system and for healthy brain function.
Often times, bariatric dietitians frown upon the starch and sweet group right after surgery. While some starches, known as complex carbohydrates, are recommended, many patients need to avoid these healthy grains for the first 6 months to 1-year post-operatively in order to make room for protein, fruits, and non-starchy vegetables.
Other starches and sweets, known as simple carbohydrates, are sugars that are easily broken down in the body and can cause a quick increase in blood sugar followed by a sudden decrease causing the body to feel sluggish. The overconsumption of simple carbohydrates, such as soda, baked goods, and white starches, can cause weight gain. These foods should be avoided for at least six months post-operatively and limited after that.
The Myth: Quantity Over Quality
No matter the surgery, having restriction is inevitable. Depending on if the patient had a Sleeve Gastrectomy (VSG) or a full Roux en Y Gastric Bypass, their stomachs are significantly smaller; about the size of a small banana or an egg respectively. Therefore, many patients feel full after just a few bites and often times end up feeling sick if they overeat. This, in turn, makes patients pick smaller meals, most often from the kid’s menu when dining out. Although many restaurants are starting to become more health conscious, bariatric patients need to think twice before ordering off of that menu.
As tempting as it can be to order a perfect sized entrée fit for the new smaller stomach, the children’s menu does not offer the right nutrients for the patient to optimize their post-operative lifestyle.
Ordering from the Kid's Menu: Just Say No!
Children’s menus are meant to appeal to children. The featured entrees are usually the high calorie, high fat or starchy comfort food that kids love.
For example, the Olive Garden children’s menu includes a wide variety of starches from pasta with all types of sauces, pizza, macaroni and cheese, chicken fingers with a side of pasta, two cheeseburger sliders, and a cheese quesadilla.
If you decide to order Fettuccini Alfredo, you are treating yourself to about 500 calories, 34 grams of fat and 450 milligrams of sodium.
Similarly, Applebee’s children's menu also includes the high calorie, high-fat options. Included in their “Hungry” and “Super Hungry” kid’s menus are entrées such as chicken tenders, macaroni and cheese, corn dogs, grilled cheese sandwiches, fried shrimp, and mini burgers. Ordering the corn dog with fries will set you back a whopping 630 calories, 31 grams of fat, and 1570 milligrams of sodium! Of course, pasta and fried foods are going to be high calorie and high fat but even the Caesar salad featured on the kid’s menu is 220 calories, 18 grams of fat, and 320 grams of sodium. Furthermore, many of these options do not include the variety of fruit and vegetables mentioned earlier.
When ordering a children’s meal, most come with combos. Both Olive Garden and Applebee’s offer their kid-sized entrees to come with a side and drink; another chance to add unnecessary calories and fat. While some of the sides offered are healthy veggies, others are high calorie fried foods such as French fries and mozzarella sticks or starches such as pasta. On top of that, the drinks on the kid’s menu include juices and sodas which are both high in calories and added sugars. Therefore, bariatric patients should really think twice before ordering off of the children’s menu.
Quality Over Quantity: Tips for Restaurant Eating
There are many options patients can choose from when enjoying a meal out. Try focusing on consuming 20 or more grams of protein per meal. Also, try to choose a meal with a cooking method that will not add extra calories to the dish. Methods such as baking, grilling, broiling, or steaming are lower in calories and fat whereas frying or pan-frying add extra unwanted calories and fat to the meal.
Patients always have the option to choose an appetizer. This is a great way to get both a small and healthy meal. When picking an appetizer be sure to pick something that’s filled with protein. If the appetizer menu is not appropriate or appealing, patients could also choose a side salad/small plate if available.
A side salad with added chicken or tuna is the perfect option for a bariatric patient as they would be getting both protein and veggies in their meal. Small plates are also a great option as they are usually the featured entrees, just made smaller. Finally, if appetizers and salads/small plates don’t cut it, a full entrée would be appropriate. Yes, a full entrée will be way too big for bariatric patients to consume in one sitting, however, the best part is that there will be plenty of leftovers! The best entrees to pick would be the ones that provide protein, fruits, and veggies, and a little healthy fat. Try substituting any starch offered for double veggies. Some other great general tips for bariatric patients to follow when eating out include:
- Checking the restaurant's menu online so you can plan your meal before arriving.
- Split a meal with a friend OR take any leftovers home.
- Avoid fried foods, cream, and sugary sauces.
- Avoid buffets as this can lead to overeating.
- Never be afraid to ask about ingredients in a certain dish; always be informed!
In summary, bariatric patients have plenty of healthy options to choose from when dining out that don’t include the kid’s menu. Sticking to options that will provide a nutritious meal is optimal for a healthy lifestyle. In this case, quantity over quality is not necessarily appropriate. So remember, when thinking about ordering from the kid’s menu, just say no!
ABOUT THE AUTHORJillian Saffie MS, RD, LDN is a Bariatric Dietitian currently working at Emerson Hospitals’ Center for Weight Loss. She graduated from the University of Massachusetts, Amherst in 2014 with a BS in nutrition and went on to pursue her Masters Degree in Exercise Science from Northeastern University. She completed her dietetic internship through the University of Houston. She did rotations at Lowell General’s Bariatric Surgery Program, Community Action Inc., and Anna Jaques Hospital. Jillian officially became registered in December 2016 and licensed in the state of MA shortly, thereafter.