PONE-D-21-14400

Prevalence of Obesity among Kuwaiti Adolescents and its Relationship with their Perception of Body Weight as seen by Parents or Friends

PLOS ONE

Dear Dr. Al-Hazzaa,

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Shahrad Taheri

Academic Editor

PLOS ONE

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Reviewers' comments:

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Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This study is interesting but have few points to consider:

Title

I suggest that the title be Prevalence of overweight and obesity among kuwaiti adolescents and the perception of body weight by parents or friends.

Keywords

I suggest replacing “weight estimation” and “obesity perception” with “body weight” and “weight perception”.

Introduction

I suggest reversing the order of references 10 and 11 in the text (lines 85-90).

Present the abbreviation of the word “body mass index” (lines 83-84) instead of putting it into methods (line 132).

Materials and Methods

Study design and participants

The researchers reported that they recruited “adolescents between the ages of 15 and 18 years” (lines 114-115). What was the criterion adopted for choosing this age group?

What was the estimated sample size? Were there losses?

How did the researchers assess whether the students suffered or not from diet-related disorders? (line 122).

Description of questionnaire

The researchers did not described about the questions “Do your parents compare your

weight with any of your brother/sister?” and “age at maturation”. How did you assess the maturation age?

Statistical analysis

In “Descriptive statistics were obtained for all variables...”, include the variables (line 157).

In the sentence “Chi-square tests of proportions were used to test differences in selected variables related to the influence of media on adolescents’ decision to lose weight...”, explain this relation of media influence (lines 160-162).

Results

The Table 3 refers to the weight status from individuals with “non-overweight or non-obesity” or “overweight or obesity”, thus why the title is written “relative to an adolescent’s overweight or obesity”?

Please, correct the 95% CI referring to the data from overweight individuals (line 201).

Discussion

The researchers mentioned that “...higher rates among males in some countries and higher prevalence among females in other countries...”, I think it is interesting to include these countries (lines 238-241).

The sentence mention about female adolescents and, what about female students? (lines 260-263).

Why did not the researchers assess the socioeconomic conditions, physical activity and food consumption? I think it is valid that you reassess and use these aspects as variables, due they are very important and can influence in the nutritional status of adolescents and in the weight perception.

Include the contributions that this study give to the society.

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Reviewer #1: No

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PONE-D-21-14400R1Prevalence of overweight and obesity among Kuwaiti adolescents and the perception of body weight by parents or friendsPLOS ONE

Dear Dr. Al-Hazzaa,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Nov 20 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Shahrad Taheri

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: (No Response)

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: ABSTRACT

-The values in this sentence “...perceived their parents (p < 0.001) or friends (p < 0.001) as more likely to classify their weight as overweight or obese” (lines 52-53) refer to the obese individuals, not the overweight people (parents: p = 0.011 and friends: p = 0.002).

MATERIALS AND METHODS

-Describe in the manuscript when the data collection was performed.

-“Chi-square tests of independence was used to examine the relationships between overweight or obesity category and selected variables related to the influence of media on adolescents’ decision to lose weight or their perception of body thinness” (lines 164-166).

It is not clear the sentence above on the use of variables related to the influence of media on adolescents’ decision to lose weight or their perception of body thinness, because the researchers didn’t show the results/discussed about it. Furthermore, in lines 157-158 it is described that “In the present study, we used the data from part three only, which was related to body weight perception by parents or friends” and it is the part two that is related to “influence of media on dieting to lose weight”. Explain.

RESULTS

-The 95% CI datum cited in the line 208 about overweight individuals is not compatible with the informed in the Table 5.

DISCUSSION

-In the sentence “other studies published over the past ‘seven’ years [2-4]” (line 226) the reference of number 4 was published in 2004. Change the description of years.

-The researchers assessed the adolescents’ perceptions of parents’ and peers’ opinions about their weight. I think it is valid to add other studies that have assessed the same (the adolescents’ perceptions of how parents and peers assess their weight). And it would be interesting to describe the reason whereby you chose to collect this information from the adolescent, not by parents/peers. Also, in the conclusion section the researchers mentioned of importance of parents’ perception (and why not from friends?), lines 311-312.

TABLE 1 - Wouldn’t the variable “overweight or obesity status (%)” be “nutritional status”?

Notes:

-Please, when checking the mentioned lines use the manuscript with tracked changes.

-Please, review the manuscript writing, words as “Portuguese” (line 248), sentences (as in lines 270-273), among others.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Prevalence of overweight and obesity among Kuwaiti adolescents and the perception of body weight by parents or friends

PONE-D-21-14400R2

Dear Dr. Al-Hazzaa,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Shahrad Taheri

Academic Editor

PLOS ONE

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