QUESTION 1 These results would be extrapolated to adolescents, aged 14 to 18, living in urban areas not far from Melbourne, with a BMI greater than 35 and presenting psychosocial complications. . Results could not be extrapolated to the general population or another region due to strict eligibility criteria, setting limitations, and study location. The population studied is so unique that no one will be able to apply the results to their population. The generalizability or external validity of the study is seriously compromised.QUESTION 2No. This is so because it helps limit the number of confounding factors or restricts confounding in the study.QUESTION 3Yes. Indeed, the participants came from different contexts, presented different predisposing factors to excess weight and randomization was carried out using a computer program. QUESTION 4 I am convinced that the allocation was concealed because the participants or investigators did not know who would participate in the program. one or the other group. Additionally, the computer system was used to assign study participants as a means of concealment, although it is unclear whether the person running the program was unaware of the study. Since the allocation was done by the computer, there was concealment because the computer did not know who belonged to either group. Additionally, analysis using SPSS software contributed to the concealment. QUESTION 5a) Blind, not blind Unknown to be blind None Study participants, parents and family members of participants, study investigators, personal trainers, medical staff, dietitian, nurse study coordinator Statistician who analyzed the data. ) They could have been blinded due to the objectivity of the study. However, it is larger than those in the lifestyle modification group, thus contributing to observer bias. This could explain the high loss to follow-up of 28% reported among those in the lifestyle modification group. QUESTION 10 Yes. It is likely that the participants were adolescents who might have sought help from newspapers about weight loss strategies and who might have been concerned about their condition. They already had risk factors for secondary outcomes like blood pressure. QUESTION 11a) No, I would not consider these results. b) The results are questionable and the internal validity is greatly compromised due to numerous biases and very restricted eligibility criteria. c) Yes; these include teenage pregnancies, side effects of gastric banding, and psychiatric disorders associated with weight loss programs..