Order a restaurant meal in this town, and odds are it'll arrive after a basket of fried tortilla chips and with a side of refried beans. The vegetables will be garnish or confined to the salsa.
It's a recipe for one hefty city -- something public health officials want to reverse. They announced a partnership Thursday with the San Antonio Restaurant Association to persuade local eateries to offer healthier options rather than face possible regulations like those that have been imposed in other cities.
"We see what's going on at the state and national level. We don't want to be mandated," said Ruben Cortez, whose family owns Pico de Gallo, the first restaurant to make menu changes through the partnership. "We want to educate the community. As they shift (what they want), we'll shift with that."
The restaurant association is encouraging members to consider adding healthier dishes, while the San Antonio Metropolitan Health District will help with dietitians and others to analyze menus and develop healthier recipes.
Mayor Julian Castro said he hasn't ruled out regulations in the future, but wants to see if the voluntary approach works first.
"I'm pleased that the restaurant association is being proactive," he said. "It deserves a chance to see if it catches on."
Those involved acknowledged they're facing a tough fight changing the city's eating habits.
Like most of the nation, San Antonio is getting heavier. More than two-thirds of area residents are overweight or obese. Statistics from the Centers for Disease Control and Prevention list only three metro areas -- Detroit, Memphis and Martinsburg, W.V. -- with higher percentages of obese residents.
Public health surveys indicate that at least 14 percent of San Antonio-area residents have diabetes, more than twice the national average.
Adding to the challenge here is the dominance of traditional foods in this majority Hispanic city: tortillas made with lard, fried chips, rich fatty cuts of meat. Many families have been eating a steady diet of such foods for generations.
Cortez's family owns five restaurants, including the landmark Mi Terra which has been serving up enchiladas, carne asada and tacos around the clock since 1951, and he acknowledged some fear of altering traditional offerings. But he said it's important for the restaurant industry to be involved in creating healthier menus.
Pico de Gallo, where diners pass a pastry case and dessert display on their way to the hostess, launched a kids' menu with some traditional but healthier fare. Cortez consulted with dietitians and others to keep dishes like tacos but added vegetable side items and low-fat milk.
He said he found that smaller portions and a few substitutions were often enough to meet the perimeters set by the dietitians. They're working on healthier dishes for adults, too.
Although obesity rates in San Antonio are substantially higher than in New York, Philadelphia and Los Angeles -- all cities that have passed ordinances aimed at unhealthy restaurant offerings -- health district director Fernando Guerra said he's hopeful that voluntary programs will move the city in the right direction without regulation.
"We've learned if you can engage the broader community in a way that is not so much top-heavy down, it generates momentum," he said.