11 Worst McDonald's Orders, According to Dietitians

For decades, McDonald's has been the beloved go-to staple and continues to soar in popularity, taking the top spot for the favorite fast food chain in 2024, according to QSR's annual report. Despite ongoing debates about health concerns, the Golden Arches is thriving, and we get it. It's hard to ignore a McDonald's craving. Sometimes, you just need to treat yourself, and while there are a few healthier options, many food items at McDonald's are packed with high calories, fat, and sodium.

To help navigate through the menu, Eat This, Not That! spoke with dietitians who revealed 11 of the unhealthiest orders. These foods have been ranked based on key health factors, including caloric density, fat content, sodium levels, sugar content, nutrient balance, and processing level. Meals that are excessively high in calories, unhealthy fats, and sodium while offering little nutritional value rank worse. Highly processed ingredients and added sugars also play a role in determining the worst offenders. By understanding these rankings, you can make more informed choices the next time you visit Mickey D's. Here are the picks, starting with number 11 and ending with the number 1 worst.

World Famous Fries

It's nearly impossible to go to McDonald's and not order fries, but Violeta Morris, MS, RDN from Columbus, OH, The Concierge Dietitian, @conciergedietitianvioleta, suggests avoiding them.

"As a dietitian, I recommend skipping the fries or opting for the smallest size possible." She says, "A small order contains 230 calories, 3 grams of protein, 31 grams of carbohydrates, and 11 grams of total fat. Research shows that foods like French fries are strongly linked to addictive behaviors, which can lead to overeating."

Morris adds, "It's easy for people to eat larger portions than they intended, even when they're not hungry. As a dietitian, I highly recommend apple slices instead of those salty, tempting fries to help you maintain a healthy lifestyle."

Bacon, Egg & Cheese Biscuit

McDonald's is infamous for its breakfast biscuit sandwiches, but Bess Berger, RDN, the founder of Nutrition by Bess in NJ, doesn't recommend the hot item.

"The Bacon, Egg & Cheese Biscuit is one of McDonalds' go to breakfasts options, but it contains 460 calories, 26 grams of fat (13 grams saturated fat), and 1,330 milligrams of sodium," she says. "The combination of processed meats and high sodium levels makes it a less healthy choice."

The McDouble® $5 Meal Deal

For just $5, you can get chicken nuggets (4 pieces), small fries, a McDouble burger, and a small Coke with the McDouble meal. It's a great deal financially, but not good for your health.

"While it may seem tempting at the moment because it offers four items for just $5, it provides 990 calories, which is high in calories but low in nutrients—often referred to as 'empty calories,'" says Morris.

She adds, "Choosing a meal like this can leave you feeling unwell after eating, and you'll likely still be hungry within a few hours. If you're focused on maintaining or losing weight, this meal is not ideal for you. While it contains 34 grams of protein, 41 grams of fat, and 126 grams of carbohydrates, it's important to consider the quality of those macronutrients."

Another harmful thing about this order is the fats and carbs are processed, "which can lead to blood sugar imbalances and make long-term weight management more difficult if consumed frequently," Morris explains.

Large Chocolate Shake

A burger, fries, and chocolate shake is a classic American meal, but a large shake at McDonald's has some serious calories.

"The Large Chocolate Shake from McDonald's is likely a tempting dessert option, but it's important to consider the additional calories and macronutrients that come with it," says Morris.

This shake alone contains a whopping 800 calories, 19 grams of protein, 134 grams of carbohydrates, and 20 grams of fat.

Morris explains, "If you're following a 2,000-calorie diet, this one item accounts for 49% of your daily carbohydrate intake." She adds, "As a dietitian, I recommend that individuals with metabolic syndrome, prediabetes, or diabetes avoid this type of option at McDonald's. If you do choose to have it, pay attention to how you feel afterward and use that experience to guide your decision the next time you're tempted to order it."

McCafé® Caramel or Mocha Frappé Large, Caramel

The McCafé Caramel or Mocha Frappé Large Caramel is a delicious afternoon pick-me-up, but it comes with a big price–high calories and a sugar crash.

Morris says, "A large McCafé® Caramel or Mocha Frappé contains a significant number of calories, with each size providing around 650 calories. This amounts to about one-third of the daily calorie intake for someone who needs around 2,000 calories daily."

Besides the high calories, the drink contains 94 grams of carbohydrates, which can lead to a sugar crash.

"This may cause your blood sugar to drop rapidly, leaving you feeling tired, sluggish, or still hungry," says Morris.

In addition, Morris says, "Research, including a systematic review and meta-analysis published in The American Journal of Clinical Nutrition, has confirmed that sugar-sweetened beverages contribute to higher BMI and weight gain in both children and adults, with each serving linked to weight increase. The next time you consider ordering this beverage, think about the potential long-term consequences for your health."

Double Quarter Pounder with Cheese

Another favorite must-have for McDonald's customers is the double quarter pounder with cheese, but it's not the healthiest, according to Berger.

"This burger contains 740 calories, 42 grams of fat (19 grams saturated), and 1,360 milligrams of sodium," she reveals. "The high levels of saturated fat and sodium can contribute to heart disease and hypertension."

McRib

People love the McRib for its tangy sauce, fried opinion and distinct taste, but Berger warns to stay away.

"This fake sandwich is made of processed meat with questionable ingredients," she explains. "It's drenched in a sugary barbecue sauce and laden in fat and sodium with little nutritional value. With 520 calories, 28 grams of fat, and 890 mg of sodium, it's definitely prudent to steer clear of the McRib."

20-Piece Chicken McNuggets

Chicken nuggets with sweet and sour or BBQ sauce have always been a popular meal at McDonald's, but Berger says it's not as healthy as it seems.

"Chicken nuggets are often mistakenly thought to be a healthier choice," she states. "Deep-fried and loaded with preservatives, this is not a healthier choice. It also contains nearly enough sodium (1,660 mg) that most people should eat in a day. A fat (48 grams) and calorie (830 calories) bomb with minimal nutrients." And that doesn't even include the sauce.

Grand Mac

The Grand Mac, which is an upsized version of the Big Mac, might sound appealing for those with a big appetite, but with 860 calories, 52 grams of fat (19 grams saturated), and 1,470 milligrams of sodium, it's one of the worst things to order.

"Its large portion size contributes to excessive calorie and sodium intake," Berger noted. "It's almost a day's worth of sodium and more calories than just about any lunch should be eating in one meal."

McFlurry with M&M's (16 oz)

Everyone deserves a sweet treat occasionally, but the McFlurry is a no-no, says Berger.6254a4d1642c605c54bf1cab17d50f1e

"This dessert option contains 930 calories, 33 grams of fat (nearly 20 grams saturated), and 123 grams of sugar. The excessive sugar content far exceeds the daily recommended intake, increasing the risk of weight gain and metabolic issues. And in no way as a dessert, this is a full meal and then some."

And the Number One Worst is….Big Breakfast with Hotcakes

Hitting the drive-thru in the morning before work is a quick and convenient way to fill up, but be wary of the big breakfast with hotcakes. While a warm, fluffy biscuit, sausage, scrambled eggs, crispy hash browns, and pancakes sound good, it's loaded with fat and sodium.

"This is a blood sugar bomb loaded with refined carbs and unhealthy fats," says Berger. "Weighing in at 1,340 calories, 158 g of carbs, 62 grams of fat, and 2,090 mg of sodium, it's a heart health disaster. This breakfast has more calories than anyone I know needs in one meal."