Diabetes vs. Restaurants: How to Attack Any Menu

How I order at almost every restaurant, why it works for my diabetes, and 10 recent restaurant meals I’ve eaten

I’m often asked, “What do you eat at restaurants? Isn’t it hard to eat low carb?”

It’s actually easier than most people think.

The excerpt below, taken from my book Bright Spots & Landmines, shares my general approach. One of the most important insights is this one:

“It’s easier to have willpower when ordering than when the food is right in front of me.”

In other words, I know I’m far more likely to make an unhelpful choice if bread, rice, pasta, potatoes, French fries, etc. are sitting on my plate. If I literally take that option off the table when I order, my default options change.

And that makes all the difference.

At the end of this article, I’ve added ten pictures of recent restaurant meals I’ve eaten. If you’d like a copy of the full book, Bright Spots & Landmines, it’s available as a free download (or name your own donation) or at Amazon for under $6. 

In restaurants, order vegetables to replace normal side dishes. 

Counting carbs is difficult in restaurants, and knowing when the food is coming makes it hard to take insulin before the meal. I rely on one ordering strategy above all others: substitute vegetables in place of whatever default side dish is included. Usually it goes something like this:

“I’ll take the salmon, but instead of potatoes, can I just get a side of vegetables?”

“I’d like fajitas please, but no rice and no tortillas. Instead, I’ll just have vegetables on the side.”

This approach is a beautiful way to change the environment and set myself up for making a Bright Spot choice. When the plate arrives, I don’t need to exercise willpower to resist the side dish – it’s simply not there to tempt me. This strategy also helps narrow the options when ordering from a big menu. I’m always looking for a main course entrée (e.g., meat, fish, eggs) that I can add a vegetable to, or a salad that looks appealing.

Waiters and restaurants are happy to make this substitution, though a small fraction make me feel slightly awkward. One time in a Thai restaurant, the waiter was astonished that I didn’t want a side dish of rice with my Chicken Ka Prow. My “special order” – yes, serving me less food – resulted in a yelling match in Thai across the restaurant with the chef. I assume it was something to the effect of, “This guy says he doesn’t want rice. Can we even do that?” Other waiters will say things like, “What, no rice?! You don’t like rice?!” But 99% of the time, they end up serving me exactly what I ask for anyways, bonus vegetables included. I always have to remember that “I’m the customer,” and it’s my diabetes at stake.

On the other hand, I always regret going with the standard order and planning to “just have a few” French fries or a “couple bites of rice” or a “sliver of the bread.” Once I have one, the floodgates are open, and I can easily finish most of the plate. “Moderation” doesn’t work for me at restaurants, which is why this ordering Bright Spot helps so much.

There are a few places where this strategy needs tweaking.

Burger and sandwich places: I’ll order a burger and ask for no bun at all, or ask for it to be wrapped in lettuce. Dealing with high BGs and sluggishness from white bread is just not worth it. I sometimes eat sandwiches open-face (one slice of whole grain bread), and I always ask for a side salad instead of fries or chips.

Mexican restaurants: I usually order fajitas with black beans and without any rice or tortillas. “Salad Bowls” are also a great option at restaurants like Chipotle, as you can avoid the rice and tortillas and just get beans, veggies, chicken or steak, guacamole or cheese, and salsa:

Otherwise, most of the core Mexican dishes have tons of carbs (tacos, burritos, enchiladas, rice, chips, etc.) that raise BG and are very difficult to bolus for correctly.

When an entire dish is based around pasta or rice: In those cases, I don’t order it and find something else. A chicken or fish dish with a side of vegetables is almost always available.

Pizza restaurants: They often sell salads, but not always. I opt for chicken wings if they are not breaded (I always ask the waiter to clarify). This is where it helps to have supportive friends and loved ones, who are happy to go somewhere else. If you do have pizza on special occasions, try ordering the thinnest crust possible to minimize carbs. (I make pizza at home using almond flour and eggs – it’s awesome and has a much lower impact on blood sugar.)

Auto-pilot ordering at restaurants: I’ll take ___ (meat, fish, eggs), but instead of the ____ (rice, pasta, bread, potatoes), can I have a side of vegetables?”

Order salads when the side-dish vegetable swap is not an option. I ask for dressing on the side, no dried fruit like raisins, and no croutons, tortilla strips, or other carb-y crunches.

Tell the waiter NOT to serve me the high-carb side dish or bring bread to the table. Often, I say “I won’t eat it,” just so they know it will definitely go to waste if they bring it. It’s easier to have willpower when ordering than when the food is right in front of me.

“Eat defensively” – fill up on veggies or other lower-carb options at home before a restaurant meal. One of my friends with diabetes uses this strategy frequently, and I love how it guards against challenging menus with no optimal choices. If I go into a restaurant meal 50%-75% full, I’m less likely to overeat or stumble on Food Landmines that drive my BG high.

10 Recent Restaurant Meals I’ve Eaten

Breakfast (“no potatoes or toast”)

Breakfast bowl with eggs and guacamole

Chinese and Thai food ("no rice")

Mexican (“no rice”, “no tostada salad shell”)

At Mexican chain restaurant, Chipotle

Tostada salad with steak, no tostada shell; salsa used as dressing

Poké (“salad base, no rice”)

Airport/Fast Food

Airport chicken Caesar salad, no croutons

In-N-Out Burger, Lettuce Bun
(A friend was visiting and wanted to go. Normally I wouldn’t eat at In-N-Out, but it is possible!)

Whole Foods salad bar and a small cup of chili

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