There are in Puerto Plata. It's not just American fast-food but in general but those with $$ tend to eat a perceived better fast-food offering.Dominicans seem to have more disposable income now. Maybe they're just eating more. Dominicans love to eat!
Take a look at some of the spandex queens on PC and there aren't any American fast food restaurants here. How do you explain that?
For the poorer there's the Dominican versions. Have you ever checked out Yaroa? LOL It's a relatively new concoction and while arguably delicious, not to me though, it's not at all good for you. https://www.dominicancooking.com/31461/yaroa#the-history
What's the count on places in Sosua selling Pizza? Most of the garbage that masquerades as pizza is, inedible to me and, unhealthy in the extreme. Ever eaten at a Dominican "hamburger" or "sandwich" cart or even the container "restaurants" by the main publico stands across Hwy 5? None of it is health food and mostly pretty new.
Feel free to continue defending all the fast food crap. I don't really care what you all eat, I have my life sorted and that's all that matters.
Carry on carrying on