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To the Editor: The incidence of obesity is rising at an alarming rate in the United States, with nearly 18% of adult Americans now considered obese.¹ High-calorie diets, due in part to the proliferation of fast food restaurants, are an important contributing factor.² Surprisingly, hospitals—institutions traditionally involved in the promotion of health-related behavior—are increasingly contracting with fast food franchises that frequently offer limited, high-fat, high-calorie menus.³ The prevalence of such franchises in hospitals across the United States is not known.

Methods

We performed a telephone survey of 16 facilities listed as "Honor Roll" hospitals by the 2001 US News & World Report on "America's Best Hospitals."⁴ Methods for constructing the list have been described in detail elsewhere.^5-6 Briefly, hospitals identified in the honor roll rank high in 6 or more of the 17 specialties evaluated in the report and were described by the magazine as demonstrating "unusual excellence."⁴ Despite some weaknesses . . . [Full Text of this Article]

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