"Public health experts have declared that there is an epidemic of obesity in this country, and they relate that to the Western diet and our reliance on high-fat, convenience foods," says University of Michigan researcher Peter Cram, MD. "For hospitals to say they promote healthy lifestyles and then offer these fast foods because it is convenient and potentially profitable is a mixed message."

Cram and colleagues surveyed 16 of the nation's top hospitals, and found that just over a third of them had at least one fast food franchise on the premises. In a research letter, published June 12 in The Journal of the American Medical Association, they wrote that while fast food restaurants, "are not solely responsible for the rising incidence of obesity, their ubiquitous presence undoubtedly contributes to the proliferation of high-fat and high-calorie diets among Americans."

"Twenty years ago people smoked in hospitals, and there was contentious debate about whether or not this was appropriate," Cram tells WebMD. "This issue has some of the same elements. If obesity is a problem, and it is related to fast food, is it appropriate for hospitals to be serving it? I think there is a strong argument that the answer is 'no.'"

University of Michigan pediatrics professor Howard Markel, MD, PhD, agrees. Markel was not involved in the research, but recently published a piece in The New York Times questioning the growing trend of allowing fast-food franchises in both hospitals and schools.

He tells WebMD that, with the exception of smoking, obesity is the biggest health risk facing this nation. He acknowledges that banning fast foods from hospitals is a more complicated social issue than banning smoking. But he adds that it is a message that should be sent, because high-fat meals like those typically ordered in fast-food restaurants are a big part of the problem.

"I like a good grilled cheese sandwich with onion rings as much as the next person, but the reality is that we shouldn't be eating that way," he says. "And we need to be setting that example in hospitals."

By Salynn Boyles, WebMD Medical News