In-n-out Burger offers a protein style menu that uses lettuce instead of hamburger buns. This is in response to customers' desire to reduce their carbohydrate intake.

We need to cut down on carbohydrates    2 $degen

I just ate, but I'm getting hungry  21 $degen

It does look delicious
They're much too large.
Can I eat it???
15 $degen

I'm hungry, but I really want to eat it. Where do they sell hamburgers?  2 $degen

It's a hamburger mania, but it looks so delicious  2 $degen

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Is it a handmade hamburger? There are a lot of vegetables in it. 10 $degen

I love vegetable salad instead of patty . 10 $degen