It's not easy to change the habits we've become accustomed to over the course of a lifetime. And for those of us who have had or are considering bariatric surgery, it's especially not easy when it comes to our eating habits.

In fact, some experts say it could take as much as 8 months to replace a bad habit with a good one. This is why gradual change is so important. There are dozens of small ways you can change your habits when eating out, so it's not necessary to swear off going out to eat just because you've had bariatric surgery.

Let’s talk about finding bariatric friendly restaurants and some alternatives. There are many ways to do this effectively - we just need to keep some considerations in mind as we do it.

Remember that we are going for gradual change here; eating out after bariatric surgery should NOT be a priority. So while these tips may take a while to become habit, it is imperative that you follow them every time for the sake of your pouch and your weight-loss success.

Fast Food

I almost didn't even want to put this section in here, because fast food is one of the main things that got me into trouble over the years, and I'm sure it hasn't helped in your case either. However, life does happen, and eventually we're going to have to be able to face whatever it throws at us. If you do find yourself needing to eat fast food, make sure you are doing it in a mindful and deliberate way.

Here are a few tips to get you through a trip to a fast-food restaurant:

• Choose grilled chicken over hamburgers. If it only comes in a sandwich, ask for it without the bun or remove it yourself.
• Instead of french fries or onion rings, try to choose sides like mashed potatoes, corn on the cob, or baked beans.
• Hit the salad bar if you can! Order a broiled chicken salad and throw some fresh vegetables over it from the salad bar. Make sure you are using only a small amount of low-fat dressing.
• Top a baked potato with cottage cheese and vegetables.

Restaurant Tips

I realize it can often be a bit more expensive, but if you have to eat out then I recommend you go to a restaurant to do so. When it comes to bariatric friendly restaurants, what you order is more important than where you go. there are bariatric-friendly items on almost any menu, you just have to find them and occasionally you might have to get a little creative.

Here are a few ways to set yourself up for success:

• Go in with a plan. Look at the menu online and decide what you will eat before you even get there.
• Start your meal with a bowl of vegetable soup. This can help prevent overeating during the meal.
• It's okay to ask how foods are prepared. Take it a step further and ask for your food to be prepared without high-fat ingredients such as butter, cream, cheese, or oil.
• You can never go wrong ordering meat, poultry, or fish. Order it broiled, baked, grilled, steamed, or poached.
• Always remove the skin from chicken.

There's one very important thing I want to mention and it's this-- absolutely NO ALCOHOL! The risk is too great. One study shows that people who undergo Roux-en-Y gastric bypass surgery could be as much as 3 times as likely to die of alcohol-related causes. The risk may not be quite as high for gastric sleeve recipients, but the overall risk of alcohol use disorder still exists.

A Word of Caution

Expect mixed emotions the first time you go out to eat following your bariatric surgery. You'll undoubtedly feel self-conscious, and to be frank - it's a bit of a bummer when you can't get the foods you used to love to eat. Ordering off the kids' menu and explaining why can sometimes be embarrassing, but just remember that these are the things we have to deal with now that we are getting healthier.

There's also the risk of going overboard the first time you go out. Please don't do this to yourself. Your pouch can't handle it, and if you're lucky enough to have avoided dumping syndrome thus far, the last thing you want to do is tie that awful experience to your first time going out post-op.

Also, remember that you are on a strict eating plan. There is a reason for that, and it doesn't go out the window just because you are going out for the night. The idea is to learn to adapt your meal out to that eating plan, not the other way around.

A few reminders:

• You need to drink at least 64 oz of water a day to avoid dehydration, but not during meals. Remember to employ the 30/30 rule- no water 30 minutes before or after your meal!
• Eat slowly to avoid dumping syndrome. Eating out for the first time is exciting, but let's make it a happy memory.
• Eat lean, protein-rich foods and avoid anything high in fats and sugar.
• Avoid alcohol.

So Where Should You Go?

As I mentioned before, where you go is not nearly as important as what you eat. Remember, you shouldn't be making a habit out of eating out, so on those rare occasions that you do, go where you want. Just remember to have a plan and order thoughtfully.

Family Restaurants

The thing about family restaurants is that they often have a large menu, which could cause you trouble if you are not prepared. The good news is that with all those choices, there's bound to be a healthy one or two! In general, a salad with some kind of protein or another is a good choice.

Try to keep it simple if you can, and get something like this:

• Vegetable and grilled chicken kabobs
• Low-sodium vegetable soup
• Broiled or grilled fish

If you're stuck, try Applebee's. their kids' menu has an excellent grilled chicken alfredo, or you can get a 4oz. steak off the kids' menu as well!

Asian Food

Asian food was one of my first post-op cravings, and the good news is that it's fairly easy to make a healthy choice! First of all, it's important to know what to avoid. Noodle dishes like lo mein and pad thai are a no-go. And you definitely want to steer clear of fried or battered meat, like sweet and sour pork or General Tsao's chicken.

So what's left? Any kind of steamed chicken or vegetables is always a great option. However, you probably want Asian for some flavor, so look to some hot and sour soup and seafood, or some grilled shrimp or chicken skewers.

Here are a few more good choices:

• Chicken, fish, or tofu stir-fried with veggies- no soy sauce though.
• Chicken tandoori
• Steamed dumplings
• Sushi or sashimi

As always, go in with a plan.

Italian Food/Pizza

"Will I ever get to eat pizza again?" I cringe whenever my friends who have had the surgery ask me this, because I want to say, "Yes, but that shouldn't be a priority right now!"

But this post assumes you've been doing everything right, and you've EARNED this trip out. So let's enjoy it! Obviously, like anything else, the best answer is to have it with veggies. A slice or two of thin crust with vegetable toppings should do the trick.

If you're going for something other than pizza, I commend you; you're stronger than I am! Here are a few other choices to satisfy your taste for Italian:

• Pasta primavera (pasta with tomato sauce or sauteed vegetables)
• Tortellini in tomato sauce
• Minestrone soup

But who am I kidding - enjoy the pizza!

Mexican Food

Making good bariatric decisions at a Mexican restaurant can be a bit more challenging, but it's not impossible. The trick is to avoid the high-carb, starchy sides in favor of veggies or lean protein like shrimp, salmon, pork loin, chicken breast, or flank steak.

The other thing about Mexican food is that some people's pouches are sensitive to it. We all know Mexican food already has a reputation to begin with, and it's not like bariatric surgery will make that any less true. So whatever you try, try a small amount first and see how your system reacts.

Try some of these ideas:

• Chicken or whole-bean soft taco- no sour cream, cheese or guac
• Chicken or fish fajita
• Arroz con pollo
• Steamed corn tortillas

Tip: Chipotle is a great choice for post-op Mexican food. You are in control of what goes in your bowl and one bowl can last you 3-4 meals. Here's a great option: black beans, no rice, chicken, lettuce, pico, medium salsa, and cheese. It's loaded with protein and it's yummy!

Don't Make it a Habit

Hopefully, if you follow this guide, you'll be able to enjoy a night out to eat without suffering any ill-effects. There's a catch-22 with this though, and we foodies are particularly vulnerable to it. If all goes well, then you'll have enjoyed a delicious meal out with friends or family, felt great afterward, and probably brought home leftovers.

If this is how it goes for you, then great! But don't make it a habit.

Bariatric surgery is a serious thing, and you should never forget that it's a lifelong commitment. Excess is what got us here, and it will be our downfall if we're not careful.

But as long as you keep that in mind, feel free to enjoy!