I have noticed how menus tend to differ regionally and internationally. During my brief stint in Ohio, they had pizza on their menu. In undergrad, I did a paper for International Business on Mickey D's.
Otherwise, I have stopped eating McDonalds. The food has become sub-par. As a child, a periodic trip to McDonald's was pure excitement as was the occasional McDonald's birthday party.
Also, if I go in for a Vanilla milkshake, it better taste like it!