Using a strict evidence-based methodology to ensure rigor and minimize bias, the Obesity Expert Panel formulated the five CQs from a broad and comprehensive list of 23 questions. The panel followed a prespecified methodological development process. The first step included a systematic review of the literature for a specific period of time and obtaining a quality rating for each of the papers meeting inclusion criteria. Generally, the panel used papers rated at least good or fair to develop evidence tables and summary tables for all five CQs. When papers rated good or fair were not available to address a specific component of a CQ, the panel used papers rated as poor quality to draw conclusions from the evidence. Due to resource constraints, efforts to address CQ1 and CQ2 relied on systematic reviews or meta-analyses rather than individual studies. For each of the CQs, the panel members reviewed the final list of included and excluded articles along with the quality ratings and had the opportunity to raise questions on citations that were missing from the literature search as well as appeal the quality ratings to the methodology team. The team then reexamined these papers and presented their rationale for either keeping or changing the quality rating of the papers. The panel members also played a key role in examining the evidence tables and summary tables to be certain that the data from each paper were accurately displayed. For CQ1 and CQ2, the panel created spreadsheets of the data from the systematic reviews and meta-analyses included in their evidence review.
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