Note: This isn’t an article on “How soon after surgery can I eat pepperoni pizza and wings?” This is an article on making the best choices you can given your situation.

Fast food is a fact of life for so many of us, so is it really reasonable to expect it to disappear from the scene after bariatric surgery?

Consider Macros

That is, “macronutrients,” or carbohydrates, fat, and protein. The news is bad on the surface since the average fast food meal has more carbs and less protein per calorie than the average home-cooked meal. You can work to turn this around, though.

Carbohydrates: Cut back on carbohydrates by skipping the starchy sides: French fries, potato chips, and hash browns, steamed, fried, or Mexican rice, and breadsticks. Try to go “green” (lettuce wrap) or “naked” (no wrap) with your burger, tortilla, or sandwich; if the fast food joint cannot honor your request, just eat the filling with a knife and fork, and throw away the bread, bun, tortilla, or taco shell (if you are feeling guilty because of starving children in third-world countries, make a donation. You’ll do more good than you would by adding starch to your hips).

Protein: How can you boost your protein intake at a fast food restaurant to be what you need? Skinless grilled or baked chicken, lean cold cuts, cheese, and beans can all up your totals, and yogurt is an increasingly common side option. Even a small burger patty can give you 10 to 15 grams of protein, although it comes with a few extra grams of fat.

A good protein goal for a meal is about 20-30 grams. You can get that for 200-300 calories with any of the following.

Burger King Double Cheeseburger, no bun; Grilled Chicken Garden Salad, no croutons; or Veggie Burger with cheese, no bun or mayo.

McDonald’s Grilled Southwestern Chicken Salad, no cheese; or Grilled Chicken Sandwich, no bun or spread.

Taco Bell 2 grilled or fresco steak soft tacos, no tortillas; chicken or steak Power Menu Bowl, no rice or cheese.

KFC Grilled Chicken Drumstick plus green beans or side salad.

Panda Express Grilled Teriyaki or Asian Chicken.

Fats: Your first order of business is to avoid anything fried. You will be avoiding excess grease while also avoiding sneaky carbs in breading – did you know that the amounts of carbs in onion rings and fried chicken are comparable to the amounts in bread? Also, watch the fatty spreads – think mayonnaise – salad dressings, and dips.

Find the Vegetables

Protein and vegetables…does this sound familiar? It should, since your goals when eating at a fast food restaurant should be the same as when you eat at home. Vegetables help fill you up without filling you out, and it is best to eat as many of them as you can handle with your pouch or sleeve. It may take a little more digging to find vegetables at fast food restaurants than at home, but you can usually do it. Here are a few leads.

Ask for extra lettuce, tomatoes, and any other available vegetables on burgers and sandwiches.

Order a side salad or baby carrots with your meal.

Check for salads with grilled chicken as an entrée.

Pile salsa and diced vegetables onto your naked burrito.

When “Value” Isn’t

Besides the convenience, the deals are among the most tempting things about fast food. For pennies more, you can often add fries and a drink, or you could get a second burger or taco for half the price. Don’t do it!

“Value” depends on what you want and need; why would you pay extra, even if it is “only pennies more,” for extra fat, sugar, starch, and calories? A healthier definition of “value” might be to pay the least you can for a meal that is convenient, delicious, and healthy. Why include “oversized” in your definition?

For those times when fast food simply makes sense, go for it – just keep yourself on track by reading the menu carefully and staying focused. You can do it, no matter where you end up. You might as well enjoy it!