PONE-D-24-40704Nutritional approach based in self-compassion versus energy-restricted diet approach in body dissatisfaction and disordered eating in adult women: a protocol for randomized clinical trial.PLOS ONE

Dear Dr. de Souza,

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Leonardo Vidal Andreato, PhD

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Partly

Reviewer #2: Partly

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3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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

Reviewer #2: 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 #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors present a protocol for a randomized trial evaluating self-compassion training versus a diet group among Brazilian women who are dissatisfied with their bodies. Both groups will attend weekly meetings for 8 weeks. Assessments will be made at baseline, 8 weeks, and 3 and 6 months after the end of the meetings. Primary outcomes are body image dissatisfaction and dysfunctional eating, while the secondary outcome will be level of self-compassion. The manuscript will be strengthened if the authors consider the following points.

1. Authors state that the study will be conducted in women who are dissatisfied with their bodies, yet there is no inclusion criterion regarding body dissatisfaction.

2. Authors mention the primary outcomes as body dissatisfaction and dysfunctional eating, but they do not specify the specific time point that will be the primary comparison. I'm guessing that will be after the meetings, so at 8 weeks, but this should be clarified.

3. In the power calculations/sample size justification, authors should specify the settings for the calculations (for example, two-sided or one-sided test, alpha level and power).

4. The statistical analysis section should provide more detail. For example, will authors compare characteristics of the groups at baseline? What will authors do if there are differences between the groups at baseline? Authors should clarify how the models they will use will handle the repeated measures across individuals. There are also 3 "after" time points. Based on Figure 2, it appears as though analyses will be repeated 3 times (at 8 weeks, at 3 months post intervention and at 6 months post intervention). It is not clear if each of those analyses will use baseline and the single follow-up time in the analysis.

5. Authors indicated weekly contact with participants to promote retention. Will that weekly contact continue throughout the follow-up period as well? Authors should indicate what sort of messages will be sent and whether they are the same for both groups.

6. In lines 262-263, authors indicate those who discontinue will be removed from analyses. Authors should clarify. For example, it might make sense to remove someone if they do not complete the 8 weeks of meetings, since all they will have is a baseline evaluation and are not providing any information regarding impact of either intervention. What about someone who drops out after the 8 weeks and doesn't return for the two additional follow-ups?

7. Authors indicate the interim analyses may be conducted to present results at scientific events and that all co-authors will have access to those results. Authors should indicate the timing of such interim analyses or requirements before even thinking about performing an interim analysis. Also, it is problematic if authors conduct an interim analysis with co-authors all seeing the results, since it is not clear if those authors are involved in delivering the intervention or contacting participants. Typically, an interim analysis is not widely shared to preserve an unbiased study team (and unbiased participants).

8. Authors mention that adverse events will be monitored. Will they also be recorded and reported on? Authors should also clarify what they will consider as adverse events (give examples).

Minor points:

1. lines 174-175 - this sentence is awkwardly phrased, so authors should consider rephrasing it or splitting it into two sentences.

2. line 265: "The data is" should be "The data are"

Reviewer #2: The study “Nutritional approach based on self-compassion versus energy-restricted diet approach in body dissatisfaction and disordered eating in adult women: a protocol for a randomized clinical trial” aimed to analyze the effects of a nutritional approach involving techniques that promote self-compassion compared to a traditional approach in women experiencing body image dissatisfaction, dietary restriction, and dysfunctional eating habits. I believe the article addresses an important and well-structured topic; however, I have a few questions discribe in the reviwer attachment.

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Reviewer #1: No

Reviewer #2: Yes:  Gabriel Fassina Ladeia

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Attachments

Attachment

Submitted filename: Reviewer Attachments for Manuscript Number PONE-D-24-40704.docx

Nutritional approach based in self-compassion versus energy-restricted diet approach in body dissatisfaction and disordered eating in adult women: a protocol for randomized clinical trial.

PONE-D-24-40704R1

Dear Dr. de Souza,

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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Kind regards,

Leonardo Vidal Andreato, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Does the manuscript provide a valid rationale for the proposed study, with clearly identified and justified research questions?

The research question outlined is expected to address a valid academic problem or topic and contribute to the base of knowledge in the field.

Reviewer #1: Yes

Reviewer #2: Yes

**********

2. Is the protocol technically sound and planned in a manner that will lead to a meaningful outcome and allow testing the stated hypotheses?

The manuscript should describe the methods in sufficient detail to prevent undisclosed flexibility in the experimental procedure or analysis pipeline, including sufficient outcome-neutral conditions (e.g. necessary controls, absence of floor or ceiling effects) to test the proposed hypotheses and a statistical power analysis where applicable. As there may be aspects of the methodology and analysis which can only be refined once the work is undertaken, authors should outline potential assumptions and explicitly describe what aspects of the proposed analyses, if any, are exploratory.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Is the methodology feasible and described in sufficient detail to allow the work to be replicable?

Descriptions of methods and materials in the protocol should be reported in sufficient detail for another researcher to reproduce all experiments and analyses. The protocol should describe the appropriate controls, sample size calculations, and replication needed to ensure that the data are robust and reproducible.

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors described where all data underlying the findings will be made available when the study is complete?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception, at the time of publication. 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

Reviewer #2: 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 #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above and, if applicable, provide comments about issues authors must address before this protocol can be accepted for publication. You may also include additional comments for the author, including concerns about research or publication ethics.

You may also provide optional suggestions and comments to authors that they might find helpful in planning their study.

(Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors have addressed all of my earlier concerns. I have no further comments to raise and am satisfied with the current draft.

Reviewer #2: The study “Nutritional approach based on self-compassion versus energy-restricted diet approach in body dissatisfaction and disordered eating in adult women: a protocol for a randomized clinical trial” aimed to analyze the effects of a nutritional approach involving techniques that promote self-compassion compared to a traditional approach in women experiencing body image dissatisfaction, dietary restriction, and dysfunctional eating habits. I believe the article addresses an important and well-structured topic

**********

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

Reviewer #2: Yes:  Gabriel Fassina Ladeia

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