WASHINGTON—Xtreme appetizers, entrées, and desserts at America's chain restaurants are making Americans fatter and sicker, and the trendy thing for chains to do is to make already bad foods even worse, according to the Center for Science in the Public Interest. Bacon cheeseburgers come nestled inside quesadillas. Half racks of ribs are promoted as side orders to steak. Golf-ball-size blobs of macaroni and cheese are tossed in the deep-fryer and served with creamy marinara sauce and even more cheese.

Welcome to the Xtreme Eating Awards for 2009. Welcome back, actually. CSPI's first Xtreme Eating report shocked the nation in 2007 with nutritional train wrecks like Uno Chicago Grill's 2,000-calorie Pizza Skins. Since the restaurant industry is showing few signs of restraint or responsibility in the face of America's epidemic of obesity and diet-related disease, Nutrition Action will make these awards an annual affair.

The Cheesecake Factory's Fried Macaroni and Cheese. With 1,570 calories and 69 grams of saturated fat, you'd be better off eating an entire stick of butter.

"Would you like an entrée with your entrée?" is how CSPI senior nutritionist Jayne Hurley imagines the logic behind items like Olive Garden's Tour of Italy, where diners can pile Lasagna, Chicken Parmigiana, and Fettuccine Alfredo onto one very large dinner plate. "It's a race to the bottom, and there's no end in sight."

Keep in mind that most people should limit themselves to about 2,000 calories, 20 grams of saturated fat, and 1,500 mg of sodium per day. And the envelopes please…

• Red Lobster Ultimate Fondue: This retro item is also making comebacks at Olive Garden, Uno Chicago Grill, and at a chain that sells nothing but fondues, The Melting Pot. Red Lobster’s Ultimate version, "shrimp and crabmeat in a creamy lobster cheese sauce served in a warm crispy sourdough bowl," is crammed with 1,490 calories, 40 grams of saturated fat, and 3,580 mg of sodium. That's two days' worth of both artery-clogging fat and blood-pressure-spiking sodium.

• Applebee's Quesadilla Burger: Here Applebee's inserts a bacon cheeseburger into a quesadilla. Two flour tortillas, two kinds of meat, two kinds of cheese, pico de gallo, lettuce, and a previously unknown condiment called Mexi-ranch sauce, plus fries, gives this monstrous marriage 1,820 calories, 46 grams of saturated fat, and 4,410 mg of sodium. Bonus heart-stopper: Applebee's actually invites customers to top the fries with chili and still more cheese.

• Chili's Big Mouth Bites: This is four mini-bacon-cheeseburgers served on a plate with fries, onion strings, and jalapeno ranch dipping sauce. ("Mini" is relative: each one is like a Quarter Pounder.) Like the "sliders" available at other chains, Chili's Big Mouth Bites can be an appetizer or an entrée (these numbers are for the latter). 2,350 calories, 38 grams of saturated fat, and 3,940 milligrams of sodium.

• The Cheesecake Factory Chicken and Biscuits: Nutrition Action calls it "discomfort food." If you wouldn't eat an entire 8-piece bucket of KFC Original Recipe plus 5 biscuits, you shouldn’t order this. But unless you live in a city with menu labeling, you wouldn’t know that this dish has 2,500 calories. The rest of the winning—or rather, losing—appetizers, entrées, and desserts are in the June issue of Nutrition Action.

According to CSPI, 2009 should be the year that Congress clues diners in by passing a menu labeling measure similar to the ones enacted in Nashville, New York City, Philadelphia, Portland, OR, California, Massachusetts, and several counties. Bills in Oregon and Connecticut have passed and are awaiting Governors' signatures. And two weeks ago, Senator Tom Harkin (D-IA) and U.S. Rep. Rosa DeLauro (D-CT) introduced the Menu Education and Labeling (MEAL) Act, which would require big restaurant chains to post calories on menu boards and list calories, saturated plus trans fat, carbohydrates, and sodium on printed menus. It would apply to the standardized items at restaurants with more than 20 outlets, and not to custom orders or daily specials.

"Ultimately, Americans bear personal responsibility for their dining choices," said CSPI nutrition policy director Margo G. Wootan. "But you can’t exercise personal responsibility if you don’t have nutrition information when you order. Who would expect 2,800 calories in a dessert?"

Menu labeling has proven popular and useful in the jurisdictions that have implemented it, according to CSPI. In a survey of New Yorkers, 82 percent of respondents said that seeing the numbers affected their choices. Though the industry tried to challenge New York's menu labeling law in court, it lost, and its prospects for challenging other laws may become dimmer still: One of the federal appellate judges that let the New York law stand is Judge Sonia Sotomayor, President Obama's nominee for a seat on the Supreme Court.