Break out the stretchy pants: The Center for Science in the Public Interest dropped its annual Xtreme Eating Awards on Thursday for the least-healthy dishes served at restaurant chains across the U.S.

Once again, the Cheesecake Factory racked up the most awards. The chain has made it onto CSPI's list every year since the group began tallying it in 2007. This year's offenders? Its Breakfast Burrito, named Worst Way to Start the Day for having the same nutritional value as seven McDonald's sausage McMuffins, and its Chicken Parmesan "Pizza Style," named Worst Adapted Pizza. (Here's the menu's description, so judge for yourself: "chopped chicken breast coated with breadcrumbs, covered with marinara sauce and lots of melted cheese, topped with angel hair pasta in an alfredo cream sauce.")

Other Xtreme Eating standouts: newcomer Shake Shack, AMC Theatres, and BJ's Restaurant and Brewhouse. Shake Shack was named "Worst Revival" for its Double SmokeShack, Fries and Peanut Butter Shake combo.

AMC Theatres' whopping 1.5-pound soft pretzel was crowned Worst Cinematic Snack with nearly four days' worth of sodium and the nutritional equivalent of six Auntie Anne's soft pretzels.

BJ's Restaurant and Brewhouse won Worst Makeup for its Peanut Butter S'mores Pizookie, consisting of "peanut butter layered on a Ghirardelli triple chocolate cookie with marshmallow fluff and marshmallows baked to a golden finish, then topped with vanilla bean ice cream," according to its website.

CSPI, a nonprofit health-advocacy group based in Washington, D.C., releases its Xtreme Eating Awards every summer. The dishes are rated by net calories, saturated fat, sodium and added sugar, with the aim of to raising awareness about the nutritional content (or lack thereof) in our meals.

Lindsay Moyer, CSPI senior nutritionist, tells Ad Age that while CSPI doesn't systematically evaluate how often chains have reformulated or removed past Xtreme Eating "winners" from their menus, occasionally they'll find calorie counts have dropped. More often, though, the dishes stay the same or even decrease in nutritional value.

"For example, the 2016 winning Uno Whole Hog Burger with fries has risen from 2,850 calories to a shocking 3,570," Moyer says.

This is the first year in the Xtreme Eating Awards' 11-year history that calorie counts are mandatory on chain restaurant menus. The calorie labels became mandatory with the Affordable Care Act of 2010, but their implementation was repeatedly delayed through the Food and Drug Administration.

Cheesecake Factory, for one, is undeterred. "With more than 250 menu items, The Cheesecake Factory has always been about choices," said Alethea Rowe, senior director of public relations for The Cheesecake Factory, in a statement to Ad Age (which, ironically, is the exact thing they told us last year when they were named to the list). "Many of our guests come in and want to celebrate and not be concerned with calories. Others want to share their dish—and we love it when guests share—that's a great sign that our portions are generous—and a large percentage of our guests take home leftovers for lunch the next day." Rowe also pointed out the chain's Skinnylicious menu, with choices under 590 calories.

Neither Shake Shack, AMC Theatres, nor BJ's Restaurant and Brewpub responded to requests for comment.