-->PONE-D-25-68898-->-->The Relationship between Obesity Talk and Body Image in Chinese Female Nursing Students: The Mediating Role of  Self-Acceptance-->-->PLOS One

Dear Dr. Xia,

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 Apr 16 2026 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 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,

Alejandro Botero Carvajal, Ph.D

Academic Editor

PLOS One

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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: Partly

Reviewer #2: Partly

**********

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

Reviewer #1: No

Reviewer #2: Yes

**********

-->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: No

Reviewer #2: Yes

**********

-->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: No

Reviewer #2: No

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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: The analytic approach fits the aims of the study, but the manuscript requires substantial revision before the results can be considered robust and reproducible.Because the design is cross-sectional, the mediation analysis must be interpreted as associational rather than causal. Several statements (e.g., in the Abstract, Discussion, and Conclusion) currently imply an intervention-oriented perspective that cross-sectional data simply cannot support. These should be significantly toned down.The statistical methods section is far too sparse to replicate the analyses. It is essential to state whether Pearson or Spearman correlations were used and why, and explain how missing data were handled. Regarding the PROCESS analysis, please describe the bootstrap procedure clearly (5,000 bootstrap resamples, not “sample size”) and report what type of confidence interval was used (e.g., percentile vs bias-corrected). Furthermore, clarify whether the reported B coefficients are unstandardized; given that the variables are on different scales, reporting standardized coefficients (β) alongside B is strongly recommended for a meaningful interpretation of effect magnitudes.Table 3/Figure 1 report the a, b, and c′ paths, but please also report uncertainty for each path (SEs and/or 95% CIs) and clarify whether coefficients are unstandardized (B) or standardized (β). This would make the mediation results easier to interpret.

BMI is reported descriptively but does not appear in the correlation table or in the mediation model. The role of BMI and the links between BMI/weight status and obesity talk, self-acceptance, and body image, are not addressed, and this omission introduces a significant risk of confounding. Please report BMI’s bivariate associations with the key variables, and consider an adjusted mediation model (or sensitivity analyses) controlling for BMI and basic demographics (e.g., age, year of study, relationship status, only-child status).Table 1 also needs re-examination: the relationship-status comparisons show very large t-values and values that are hard to reconcile with the other descriptive statistics, which suggests possible data-reporting error or formatting problems. Verify the table and ensure the tests are reported correctly, including degrees of freedom, exact p-values, and effect sizes. Given the number of outcomes and demographic comparisons, I also suggest stating whether any correction for multiple comparisons was applied.

In addition, the footnote under Table 2 (** indicates p<0.05) may be confusing, since "**" is often used for smaller p-values, and elsewhere the manuscript frequently reports p<0.001.

Regarding the instruments of measure, the manuscript lists cut-offs/score ranges for the Fat Talk Scale and the BISS, but it is unclear whether these are validated thresholds and whether they were used analytically or only as descriptive categories. Please provide sources for these thresholds and clarify whether scores were handled as continuous or categorical in the actual analysis. Reliability is reported from a small pre-survey (80), report reliability indices for the full sample (1280) as well. Clarify whether validated Chinese versions of the BISS and Fat Talk Scale were used, and describe translation/adaptation procedures if applicable.

In the Introduction and Discussion, the authors suggest that obesity talk is perceived as supportive or normative, yet perceived valence is not measured. This should be presented as a possible interpretation rather than a mechanism demonstrated by the data. Additionally, given the close links between body image and eating-related symptoms, it would strengthen the limitations to acknowledge that disordered eating was not assessed (e.g., restraint, binge eating, compensatory behaviors), as this could be relevant to interpretation and to future model extensions. The Data Availability Statement is very general.

Finally, the sampling procedure would benefit from clarification. The manuscript describes cluster random sampling, but survey administration is described as distribution via a QR code through WeChat/QQ. Please explain how the sampled clusters were approached and how participation was limited to the selected classes. The manuscript is generally understandable, but the English and statistical phrasing should be edited carefully (there are incomplete sentences and imprecise expressions such as “p<0.05 indicated the difference”), and terminology should be made consistent (obesity talk/obesity discussion; body image/body imagery).

Reviewer #2: The study addresses an interesting and culturally relevant question: whether “fat talk” (here labelled “obesity talk”) is positively associated with body image among Chinese female nursing students, and whether self-acceptance mediates this relationship. The topic is suitable for PLOS ONE, but in its current form the manuscript has several major methodological, statistical and interpretative limitations, in addition to important language issues. I therefore recommend major revision. My main comments are below.

1. Sampling and design

1.1 The sampling procedure is described as “cluster random sampling” of classes across five medical universities, but data collection was conducted via QR code links distributed on WeChat/QQ. It is unclear how clusters were actually selected, whether all students had an equal probability of inclusion, and how many invited participants did not respond. Please describe the sampling frame and recruitment process in detail and avoid labelling the sample as random if it is essentially convenience based.

1.2 A very high response rate is reported (91.6%; 1280/1398). For an anonymous online survey, this is unusually high. Please clarify how this rate was calculated (e.g., number of students formally invited vs. number who opened and completed the survey) and whether any questionnaires were excluded (e.g., missing data, inattention).

1.3 The study is cross sectional and fully self report. Nevertheless, the Abstract, Results and Discussion frequently use causal language (e.g., “obesity talk positively predicted body image”, “fat talk improves body image via self acceptance”). Please rewrite all sections to make clear that only cross sectional associations are tested and that no causal effects can be inferred.

2. Measures and constructs

2.1 The manuscript uses the Fat Talk Scale (Clarke et al., 2010), the Self Acceptance Questionnaire, and the Body Image States Scale. However, information on Chinese translations/adaptations is minimal. Please state clearly which validated Chinese versions were used, how translation/back translation was handled, and provide psychometric references for these versions.

2.2 Cronbach’s alpha values are reported only for a small pre survey sample of 80 students. Reliability should be reported for the full analytical sample; pretest values are not sufficient.

2.3 The BISS cut off of ≥25 for “positive body image” is described, but analyses treat body image as a continuous variable and never use this dichotomy. Either justify the use of this cut off with appropriate references and analyses, or remove it from the Methods to avoid confusion.

2.4 Conceptually, “fat talk” is generally understood in the literature as negative, self deprecating body talk and is usually associated with higher body dissatisfaction. In this study, fat talk correlates positively with body image. This is a very counterintuitive pattern that requires much deeper theoretical and measurement discussion (e.g., whether the Chinese version of the scale may capture more supportive or normalizing weight related conversations rather than negative fat talk).

3. Statistical analysis

3.1 The mediation analysis using PROCESS Model 4 with bootstrapping is appropriate in principle, but it is conducted without any covariates. Table 1 shows large and statistically significant differences in obesity talk, self acceptance and body image by relationship status. Relationship status (and potentially age and BMI) should be included as covariates in the mediation model, or there should be a strong justification for not controlling for these variables.

3.2 The reported t value for obesity talk by relationship status in Table 1 (t = 46.023, p < 0.001) is implausibly high given the sample size and standard deviations. This suggests a possible calculation or typographical error. Please re check the descriptive statistics and inferential tests in Table 1 and correct any errors.

3.3 Effect sizes are small and are not discussed. The correlation between obesity talk and self acceptance is r = 0.124 (R² ≈ 0.015), and the indirect effect via self acceptance accounts for only about 6.5% of the total effect. These values should be explicitly reported and the practical significance of such small effects discussed more cautiously. At a minimum, the Discussion should emphasize that self acceptance plays only a modest role in the association.

3.4 No power analysis is provided. Given the small effect sizes, it would be useful either to report a priori power calculations (if available) or to conduct a post hoc sensitivity analysis showing the smallest detectable effect size with the present sample.

3.5 Please report more details about the statistical procedures: how missing data were handled (listwise deletion, imputation), whether assumptions of linear regression (normality of residuals, homoscedasticity, multicollinearity) were checked, and which exact tests were used for group comparisons in Table 1 (t tests, ANOVA).

4. Interpretation and discussion

4.1 The counterintuitive positive association between fat talk and body image is a potentially important finding, but it is currently interpreted in a way that may overstate its robustness. The Discussion should engage more critically with the existing Western literature that typically finds negative associations, and clearly acknowledge alternative explanations (measurement issues, social desirability, sample characteristics, confounding).

4.2 The mediating role of self acceptance is described as if it were a strong explanatory pathway. Given the small indirect effect and cross sectional design, the wording should be softened (e.g., “self acceptance accounted for a small portion of the association”) and the possibility of other mediators or moderators (e.g., perceived social support, media exposure) should be highlighted.

4.3 The Limitations section should be expanded to include: (a) the non random and geographically restricted sample; (b) the exclusive use of self report measures and the possibility of common method bias; (c) the lack of covariates in the mediation model; and (d) the absence of longitudinal or experimental data.

5. Reporting, language and formatting

5.1 English writing requires substantial revision by a fluent or professional editor. There are many grammatical errors and awkward expressions (e.g., use of future tense in Methods, inconsistent naming of variables, “Love status” instead of “Relationship status”). Clearer writing will greatly improve the accessibility of the manuscript.

5.2 Terminology must be made consistent throughout the manuscript. I strongly recommend choosing one term (preferably “fat talk”, which is standard in the literature) and using it consistently in the title, abstract, text, tables and figure. Similarly, use “body image” rather than “body imagery”.

5.3 Tables and figure need some technical corrections: (a) fix the note in Table 2 (“** indicates p < 0.05”) so that it is consistent with the reported p values; (b) consider adding effect sizes (e.g., η²) for group comparisons; and (c) in Figure 1, clearly label the paths, indicate whether coefficients are standardized or unstandardized, and add confidence intervals if possible.

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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.

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Reviewer #1: No

Reviewer #2: No

**********

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NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications.

<div>PONE-D-25-68898R1-->-->The Relationship between Fat Talk and Body Image in Chinese Female Nursing Students: The Mediating Role of  Self-Acceptance-->-->PLOS One

Dear Dr. Xia,

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 May 23 2026 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 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.

As the corresponding author, your ORCID iD is verified in the submission system and will appear in the published article. PLOS supports the use of ORCID, and we encourage all coauthors to register for an ORCID iD and use it as well. Please encourage your coauthors to verify their ORCID iD within the submission system before final acceptance, as unverified ORCID iDs will not appear in the published article. Only  the individual author can complete the verification step; PLOS staff cannot  verify ORCID iDs on behalf of authors.

We look forward to receiving your revised manuscript.

Kind regards,

Alejandro Botero Carvajal, Ph.D

Academic Editor

PLOS One

Journal Requirements:

If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise.

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 #1: (No Response)

Reviewer #2: All comments have been addressed

**********

-->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: Partly

Reviewer #2: Yes

**********

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

Reviewer #1: Yes

Reviewer #2: 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

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. 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: Major concerns:

1. Critical internal inconsistency of results across response letters and manuscript files. The revision package contains incompatible values for key results, and it is unclear which statistics are final. Importantly, the mediation analysis appear to have different numbers for the same adjusted mediation analysis: one reports an indirect effect of 0.021, whereas another reports an indirect effect of 0.174 (and the revised manuscript/abstract also reports 0.174 and 57.80% mediation). This is not acceptable without a formal clarification. Please provide one single, coherent set of final results, clearly distinguishing unadjusted vs adjusted models (if both are reported), and ensure the same numbers are used consistently across the Abstract, Results, Tables/Figures.

2. The tracked-changes manuscript is not cleaned and contains concatenated/duplicated statistics. While it is expected that tracked changes display deletions and insertions, the current tracked version contains clear editing artifacts (e.g., concatenated correlation coefficients such as "0.457543" and mixed significance markers) and duplicated blocks of results, making it impossible to determine which statistics are final.

Please submit a cleaned tracked-changes file where all non-final results are clearly marked as deletions (and not left readable as parallel results), and where only one coherent set of final results remains interpretable.

3. Table 1 requires a formal explanation of changes; degrees of freedom still missing. Table 1 appears to contain values that changed beyond formatting corrections. Degrees of freedom (df) remain absent from Table 1. Please report df for all relevant tests (t-tests/ANOVA), along with appropriate effect sizes and exact p-values.

4. BMI bivariate associations remain insufficiently reported.

BMI was explicitly requested as a potential confounder. While BMI is now included as a covariate in the adjusted model, the manuscript should also report BMI's bivariate associations with the key variables (fat talk, self-acceptance, body image), e.g., by adding BMI to the correlation matrix or providing a separate table.

5. Data Availability Statement remains too general for PLOS ONE requirements. The statement still reads as a generic formula, but the editorial decision letter asks for confirmation that the submission includes the minimal dataset needed to replicate results. Please specify exactly where the minimal dataset is available, and provide a brief data dictionary/coding description if possible.

Minor concerns:

Interpretation of the mediator is still overstated in the Conclusion. The Conclusion describes the mediation as accounting for a "substantial portion (57.80%)" of the association, which sits uneasily with the standardized indirect effect reported in the manuscript (β = 0.080) and with the authors' promise to soften wording (e.g., "small portion"). Please ensure consistent and appropriately cautious interpretation across Abstract, Discussion, and Conclusion. Remaining causal language. Use strictly associational language consistent with a cross-sectional design. Statistical reporting/formatting. Avoid "P = 0.000" (use p < 0.001 or exact p-values), and standardize significance notation consistently across tables and text (e.g., p < 0.05, p < 0.01, p < 0.001).

Chinese Fat Talk Scale version: insufficient documentation of validation. The manuscript states that a Chinese version was produced via internal translation/back-translation. If no published, validated Chinese version exists, this should be framed as an important methodological limitation and the translation/adaptation procedures and psychometric support should be reported as fully as possible (or a peer-reviewed validation reference should be provided). Reference list clean-up. Please check for duplicate entries and inconsistent formatting in the reference list.

Reviewer #2: (No Response)

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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

Reviewer #2: 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.]

To ensure your figures meet our technical requirements, please review our figure guidelines: https://journals.plos.org/plosone/s/figures

You may also use PLOS’s free figure tool, NAAS, to help you prepare publication quality figures: https://journals.plos.org/plosone/s/figures#loc-tools-for-figure-preparation.

NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications.

-->

<div>PONE-D-25-68898R2-->-->The Relationship between Fat Talk and Body Image in Chinese Female Nursing Students: The Mediating Role of  Self-Acceptance-->-->PLOS One

Dear Dr. Xia,

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 Jun 14 2026 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 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.

As the corresponding author, your ORCID iD is verified in the submission system and will appear in the published article. PLOS supports the use of ORCID, and we encourage all coauthors to register for an ORCID iD and use it as well. Please encourage your coauthors to verify their ORCID iD within the submission system before final acceptance, as unverified ORCID iDs will not appear in the published article. Only  the individual author can complete the verification step; PLOS staff cannot  verify ORCID iDs on behalf of authors.

We look forward to receiving your revised manuscript.

Kind regards,

Alejandro Botero Carvajal, Ph.D

Academic Editor

PLOS One

Journal Requirements:

1. If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise.

2. 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.]

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)

**********

-->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

**********

-->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

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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 #1: The manuscript is substantially improved and now presents a single coherent set of mediation results, and BMI has been added to the correlation matrix. However, several issues remain before the paper can be considered publication-ready.

- Data Availability (DOI not working):

Please make the Data Availability Statement consistent and fully PLOS-compliant. In your response letter you provide a Figshare DOI (10.6084/m9.figshare.28345678.v1), but when I tried to open it, it returned DOI NOT FOUND. Please verify that the DOI is correct and activated, and that the repository item is publicly accessible without restriction. The manuscript currently still states: All relevant data are within the paper and its Supporting Information files.

This must be updated to the correct working public DOI/URL, and the statement should specify what files are provided (dataset + data dictionary/codebook).

- Ethics/IRB approval number inconsistency:

Please verify the correct IRB approval number and report it consistently throughout all materials. The response letter / ethics form reports 20250317, while the manuscript Methods reports 20240317.

- Incomplete sentence about indirect-effect significance:

Please complete the sentence describing the mediation significance criterion: it should state that the 95% confidence interval does not include 0 (zero); (currently the sentence is incomplete).

- Bootstrap:

Please correct the bootstrap wording. The manuscript currently refers to “choosing 5,000 as the sample size,” which is incorrect. The study sample size is the number of participants included in the analysis (N = 1,280). 5,000 refers to the number of bootstrap resamples used to estimate the confidence interval for the indirect effect. Please revise the wording accordingly (e.g., bootstrapping with 5,000 resamples).

- p-value:

Please do not report p-values as “0.000” (or p<=0.0001). Use p < 0.001 or report exact p-values where available (e.g., p = 0.009), consistently across text and all tables.

- Table cross-references:

Please correct table cross-references. The text currently refers to mediation results “as shown in Table 2,” but the mediation decomposition is reported in Table 4.

- Associational language (cross-sectional design):

Please replace remaining causal verbs (e.g., predicts, affects, improves, influences) with strictly associational language appropriate for cross-sectional data (e.g., is associated with, is linked to).

- Terminology consistency:

Please use one main term consistently (preferably fat talk, as in the title and scale name). The manuscript still switches between fat talk, obesity talk, and obesity discussion (e.g., Abstract/Methods and section headings). If these are intended as synonyms, please standardize them; if they are intended as distinct constructs, please define them explicitly.

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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.

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Reviewer #1: No

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To ensure your figures meet our technical requirements, please review our figure guidelines: https://journals.plos.org/plosone/s/figures

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<p>The Relationship between Fat Talk and Body Image in Chinese Female Nursing Students: The Mediating Role of  Self-Acceptance

PONE-D-25-68898R3

Dear Dr. Xia,

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,

Alejandro Botero Carvajal, 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 #1: 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 #1: Yes

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

Reviewer #1: Yes

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-->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: 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

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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 #1: (No Response)

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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

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