PONE-D-23-16906Socioeconomic status and older adult’s experiences of weight loss: a qualitative secondary analysisPLOS ONE

Dear Dr. Newton-Clarke,

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.

==============================Overall, I agree with the comments of Reviewer 1--please attend carefully to their comments both in the review itself and in the annotated manuscript. Additionally, please better define the inclusion criteria (namely, please include how "at risk for frailty" was operationally defined) and include more information on the demographic characteristics of the participants (e.g., gender, race/ethnicity) to better contextualize the findings. Please include information on how participants were recruited and the purpose of the primary study for which they were originally recruited. Finally, please carefully proofread the manuscript for spelling and grammar.

==============================

Please submit your revised manuscript by May 17 2024 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.

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We look forward to receiving your revised manuscript.

Kind regards,

Emily Lund

Academic Editor

PLOS ONE

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[I have read the journal's policy and the authors of this manuscript have the following competing interests: Fliss Murtagh is a National Institute for Health and Care Research (NIHR) Senior Investigator. The 

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Additional Editor Comments:

Overall, I agree with the comments of Reviewer 1--please attend carefully to their comments both in the review itself and in the annotated manuscript. Additionally, please better define the inclusion criteria (namely, please include how "at risk for frailty" was operationally defined) and include more information on the demographic characteristics of the participants (e.g., gender, race/ethnicity) to better contextualize the findings. Please include information on how participants were recruited and the purpose of the primary study for which they were originally recruited. Finally, please carefully proofread the manuscript for spelling and grammar.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

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: Yes

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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?

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: Yes

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4. 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: 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: Reviewer comments PONE-D-23-16906

Introduction

The authors have provided a very limited review of the literature with although the argument for the social and scientific value is logical. This can be improved on by correcting minor grammatical errors and ensuring the quality of literature referenced is more recent data. The statement for the aim should be revised as it contains a repetition that in my view is unnecessary.

Methods

This was a secondary analysis of anonymized data from previously concluded research.

The authors have provided a very thorough description of the process used in data analysis. The diversity among authors would offer adequate diversity The engagement between the authors seems quite robust and is adequate.

Results

The authors have presented results adequately with a good number of participant statements to illustrate the themes and sub themes.

Discussion

This could be improved with comparison with more studies, although few studies have looked directly at the subject, there is a lot of research in behaviour change and diet in weight gain. However, the authors have a clear section describing the implications of their findings for clinical practice and further research. They have also clearly outlined the limitations of this study in looking at the subject especially as it concerns exhaustive exploration of the subject for this study. This fact may have limited the findings but is an indication for further research.

Conclusion

This clearly outlines the main findings and outlines the need for behaviour change in the attitude of clinicians in consultation with older adults with unintentional weight loss.

Clinicians are obliged to empower patients further in correcting misinformation and misconceptions about weight loss.

References

As mentioned earlier, the authors should present more recent data, and consider including more studies in the presentation of the scientific and social value for this study. The comparison with other research can be improved upon.

The style of referencing is correctly done

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6. 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.

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Reviewer #1: No

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Attachments

Attachment

Submitted filename: PONE-D-23-16906_reviewer.pdf

PONE-D-23-16906R1Socioeconomic status and older adult’s experiences of weight loss: a qualitative secondary analysisPLOS ONE

Dear Dr. Newton-Clarke,

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.

==============================

The work is interesting and potentially appropriate for publication in PLOS ONE. However, reviewers #2 and #4 have raised a number of concerns that prevent us from accepting the manuscript in its current form. We would like to be able to reconsider the manuscript and hope you can successfully address the concerns outlined below by the reviewers.

Key Areas for Improvement:

1. Kindly strengthen the background of your paper (Reviewer #4).
2. Address the trustworthiness issue that Reviewer #4 brought up in relation to the methods section.
3. Review carefully for grammatical and punctuation errors, especially following citations (Reviewer #2).

In summary, I encourage you to address all the reviewers' comments and make the necessary revisions, particularly in improving the abstract, introduction, method, and discussion sections. I look forward to reviewing your revised manuscript.

==============================

Please submit your revised manuscript by Jan 22 2025 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,

Godwin Banafo Akrong, Ph.D.

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.

[Note: HTML markup is below. Please do not edit.]

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 #2: (No Response)

Reviewer #3: All comments have been addressed

Reviewer #4: All comments have been addressed

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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 #2: Yes

Reviewer #3: Yes

Reviewer #4: Partly

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

Reviewer #2: Yes

Reviewer #3: Yes

Reviewer #4: 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 #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

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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 #2: Yes

Reviewer #3: Yes

Reviewer #4: Yes

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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 #2: The study acknowledges differences in participants’ experiences based on socioeconomic status (SES), such as those in more deprived areas feeling more passive in healthcare interactions or experiencing greater food-related guilt. However, it does not adequately explore the reasons behind these differences or their connections to structural inequities. A more thorough examination of these underlying causes and their implications would enhance the study’s contribution to understanding SES-related disparities.

Additionally, the manuscript would benefit from a careful review for grammatical and punctuation errors, especially following citations.

Reviewer #3: 1. The manuscript is technically sound, and the data do support the conclusions.

2. The statistical analysis has been performed appropriately and rigorously.

3. The authors have made all data underlying the findings in their manuscript fully available.

4. The manuscript is presented in an intelligible fashion and written in standard English.

Reviewer #4: Review Comments

Abstract: Lacks clarity

Background: Not strong

Methods:Not explicit mainly the trustworthiness of the study is not well stated.

Results;Lacks logical flow

Discussion: Not comprehensive and lacks theoretical and practical implications

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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 #2: Yes:  Anastasia Akosua Asantewaa

Reviewer #3: Yes:  Kassa Demissie Abdi (PhD)

Reviewer #4: No

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[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.

Attachments

Attachment

Submitted filename: Manuscript Complete 26.06 (1)(1)_2.docx

Socioeconomic status and older adult’s experiences of weight loss: a qualitative secondary analysis

PONE-D-23-16906R2

Dear Dr. Newton-Clarke,

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.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Godwin Banafo Akrong, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

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 #2: All comments have been addressed

Reviewer #3: All comments have been addressed

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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 #2: (No Response)

Reviewer #3: Yes

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

Reviewer #2: (No Response)

Reviewer #3: 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 #2: (No Response)

Reviewer #3: Yes

**********

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 #2: (No Response)

Reviewer #3: Yes

**********

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 #2: (No Response)

Reviewer #3: 1. All comments have been addressed.

2.The manuscript is technically sound, and the data do support the conclusions.

3.The statistical analysis has been performed appropriately and rigorously.

4.The authors have made all data underlying the findings in their manuscript fully available.

5.The manuscript is presented in an intelligible fashion and written in standard English.

**********

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 #2: No

Reviewer #3: Yes:  Kassa Demissie Abdi (PhD)

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