Overweight children and adolescents.

A seven-year-old girl is 130 cm tall (51 in., the 90th percentile for girls ofthe same age) and weighs 34.6 kg (76 lb, above the 95th percentile), with a body-mass index (defined as the weight in kilograms divided by the square of the height in meters) of 20.5 (above the 95th percentile). Physical examination reveals no abnormalities aside from her excess weight. Her family eats at a quick-service restaurant once a week, and she drinks approximately 16 oz (450 ml) of soft drinks and 8 oz (225 ml) of whole milk per day. Her physical activity is limited to 30 minutes of physical education twice per week and 20-minute recesses three days per week in school. She has approximately 4.5 hours of screen time per day, which is divided among the television sets in her bedroom and in the family room and the family computer. What should you advise?