A “Bariatric Restaurant Card” is a card the size of a business card, usually laminated, provided to post-bariatric patients by surgeons. The card usually says:
"The person who presents this card has had a bariatric surgery which has permanently reduced their stomach capacity. Therefore… It is greatly appreciated if you would allow them to order from the children’s menu or to purchase half-sized adult entrees. Thank you for your consideration."
Bariatric surgery is becoming a more popular approach to managing obesity, with hundreds of thousands of Americans now electing to have the procedure each year. The surgery involves either the use of a medical device called a gastric band, which reduces the size of the stomach, the removal of part of the stomach, or the rerouting of the small intestines to a pouch in the stomach (known as gastric bypass surgery). Bariatric surgery may seem like an extreme method to dealing with obesity, but indications are that it works.
Those who undergo bariatric surgery can lose anywhere from 70-120 pounds, depending on the type of procedure. It also improves symptoms of diabetes and causes a reduction in cardiovascular symptoms that can occur due to obesity. Overall, it can be responsible for a lowering of mortality rates in obese patients, from 40% to 23%.
Those who undergo bariatric surgery have a drastically reduced stomach capacity, and their success in maintaining their new weight is dependent upon not chronically overeating. Chronic overeating can stretch out the stomach, allowing the patient to eventually gain weight again. But most bariatric surgery patients don't have the ability to eat what we consider normal portion sizes in America. This makes going out to eat both expensive and impractical.
In an attempt to change this, patients have now started bringing Weight Loss Surgery (WLS) cards to restaurants with them. These cards, which are signed by a surgeon, indicate that the person should be eligible for smaller portion sizes in order to accommodate their surgically-modified stomach. A number of restaurants, including Cracker Barrel, Red Lobster, and Olive Garden, have already come out to say they will honor the use of these cards, and many others are sure to follow suit.
Growing Popularity of Weight Loss Surgery Cards
The growing popularity of these cards among bariatric surgery patients raises two questions: 1) are these cards a good idea? and 2) shouldn't anyone be eligible to use them?
The reason why some believe WLS cards are not a great idea is that they encourage people to go to restaurants that generally have unhealthy food, regardless of the portion sizes. Bariatric surgery patients might have been avoiding these restaurants in the past, but now armed with their WLS card they may decide to patronize one. Even if they are getting limited portions, it's not beneficial for them to take in high calorie and high fat food.
On the other hand, some argue that these patients should be able to enjoy some unhealthy food in moderation. For example, Ann Rogers, who directs the Surgical Weight Loss Program at Penn State University, states that it's okay to eat unhealthy food occasionally. As long as patients eat healthy 75% of the time, she says, their weight will stay off.
The Bottom Line
So, if we are willing to condone bariatric surgery patients using WLS cards at restaurants, the question is why is this limited to these patients only? As evidenced by the high numbers of bariatric surgery, we have an obesity epidemic in the United States. A contributor to that problem is the size of meals we get when we get food from restaurants, fast food or other. Wouldn't it be beneficial if more people could carry WLS cards, so that our portion sizes as a country might go down?
Restaurants, however, may put up more of a fight about expanding WLS use to non-patients. After all, their large portion sizes are part of what brings their customers back repeatedly. More importantly, WLS cards allow customers to get smaller portions at a discount, and if too many people used them it would cut into restaurants' profits.
So, seeing widespread use of WLS cards remains unlikely. However, it should be a reminder to us as a country that our large portion sizes are contributing to our obesity problem. After all, it seems like a somewhat ridiculous scenario: we have to surgically alter our stomachs so we can't consume such large portions, then we have to carry around a card which makes us eligible for special portion sizes (which are similar to what we should have been eating from the beginning). Although the cards are helpful to bariatric surgery patients, the real change that needs to be made is to make portions smaller, across the board.