On a recent Friday, the Cleveland Clinic's food court was a microcosm of America's struggle with obesity.
At 1 p.m. in the nation's leading heart care hospital, a crowd of diners, many wearing scrubs or white lab coats, lined up at McDonald's, where the irony was as thick as the Big Macs on the menu.
"Every now and again I stray just a little," Rodney Maynor, a clinical technician at the hospital, confessed between bites of fries. "I don't eat too much of it. I just wanted it right now."
Come September, however, the Clinic will finally bounce the fast-food chain from its food court, discontinuing a long-term lease that has allowed McDonald's to operate there for two decades. A Clinic spokeswoman said the restaurant will close Sept. 18.
"We want to demonstrate that we can walk the talk by being a healthier organization," said the spokeswoman, Eileen Sheil, who added that removing McDonald's is part of a much broader wellness campaign at the hospital.
Clinic chief executive Toby Cosgrove, himself a cardiac surgeon, has been trying to get rid of the Golden Arches for more than a decade, but the chain asserted its right to continue operating in the Clinic's food court under the terms of its lease.
On Monday, the franchisee who owns the Clinic's McDonald's, issued a statement expressing pride in his business and its connection to the hospital's workers and patients.
"My family and employees have enjoyed serving the Cleveland Clinic community for the past 20 years," said franchisee Turan Strange. "...We invite families and residents in the hospital community to visit our other Cleveland-area restaurants for the variety of balanced choices of food and beverages that we're proud to serve."
The statement also said that employees of the food-court franchise will be offered jobs in Strange's other restaurants.
Despite its popularity, the McDonald's in the Clinic has long stood at a precarious crossroads, where America's love of free enterprise and fatty fast-food is clashing with a full-blown health care crisis.
More than two-thirds of the country's population is now classified as overweight or obese, according to a recent report published by the Journal of the American Medical Association. Studies show that being overweight increases a person's risk of heart disease, hypertension, type 2 diabetes, stroke, and certain types of cancer. Furthermore, the Centers for Disease Control and Prevention estimates obesity costs about $147 billion annually in medical bills, as well as another $3.4 billion in lost productivity.
Though McDonald's no longer uses trans fat to cook fries or baked goods, some of its items are laden with sugars and high amounts of sodium that contribute to an unhealthy diet and chronic disease.
In many cases, patients stricken with obesity-related illnesses, particularly heart disease, end up at the Clinic for their care. The hospital network has been No. 1 in heart care for 21 years, according to annual ratings published by U.S. News and World Reports.
Under Cosgrove, the Clinic has launched a long-term effort to improve the health of its employees. It has removed the fryers from its food court and added healthier options, including a "Cooking Light" kitchen and a station that serves rice bowls and pitas with fresh vegetables and rice.