Title: Socio-demographic predictors of obesity among women in Mukono Central Division in
Central Uganda: A cross-sectional study
Version: 4 Date: 15 May 2023
Reviewer's report:
Thank you for the opportunity to review this manuscript. This study aimed to determine the
socio demographic predictors of obesity defined using total body fat % among women 18 to 59
years living in Mukono Central Division in Central Uganda. This is an interesting study as most
studies in Uganda either focus on children and adolescents, or adults with medical conditions
(diabetes, HIV) or use anthropometry to assess obesity.
The authors did not seem to follow the Author Guidelines, this limited the quality of an otherwise
well-written manuscript. For example, the Vancouver referencing style has not been used, and
sources are cited in the text using (author, year) instead of the numbering system. Secondly,
some abbreviations are not written out in full when first used in the text, for example BMI, TBF
% at the beginning of the Background; VIF (line 231). They have also used a tab at the beginning
of each paragraph.
The sub-section title, "Justification" on page 4 does not appear to me to be necessary. I think the
content is part of the Background. The sub-section title "Justification" should be omitted and
the aim of the study (lines 70-71) should be moved to the end of this sub-section.
Methods
Line 145: Declining to consent is not an exclusion criterion. The potential participants have
declined, and are therefore not part of the study and cannot be excluded from a study they are
not part of.
Lines 152-153:  In the sample size calculation, the authors used the total prevalence of
overweight, obese and underweight women. My understanding is that they wanted to establish
the prevalence of obesity among women as the dependent variable. They should provide
a justification for including the other two categories, and most especially the underweight
category.
Lines 161-163: The authors state that they used simple random sampling, but this is not the case.
The study employed stratified sampling. SRS  was used after the stratification. The explanation
of two-stage sampling is not necessary as the description of what they did will make it very clear.
Lines 167-169: The authors state that the municipality has 4 parishes/wards. They also say they
selected four villages from each of the parishes. They should therefore have 16 villages, but state
(and name) only 4 villages. This should be clarified.
If possible, a map of the municipality showing the location of the selected villages would be
useful to show the distribution.
The authors also need to explain how the sample size of 384 was distributed between the 4
villages
The authors should explain how the households were selected by simple random sampling. Did
they have, for example a list of households and use that?
Line 228: Creswell et al 2003 is not on the list of references. It can be excluded, it does not
seem to add any value.
Results
The caption/legend at the bottom of Table 1 giving the source of the data is not necessary.
Lines 243-252 have information that is redundant because all variables have two categories. So
if one category, for example secondary education or lower is 88%, it is obvious that tertiary
education is 11% and moreover this is evident in the table.
Line 253: Prevalence of malnutrition is misleading. Malnutrition includes over-and
undernutrition. It should be very specific, Prevalence of obesity by total body fat%
Table 3 is not necessary, those results can be given as text.
Table 4: All variables as presented in Table 2 should be presented in Table 4, and results of
univariate analysis shown. This is important because ideally it will help in the selection of
variables to include in the final model.
Table 5 would be better presented, I think, with the ORs first, then the CI, then B(SE) last.
Discussion
The authors should consider discussing whether the socioeconomic and demographic
characteristics are plausible, ie how do they compare perhaps to UDHS for urban residence, or
for the region in which Mukono is located. They have also limited the discussion to Employment
status, yet the Background was quite broad. The authors should also consider whether the other
variables behaved as expected (based on the Background and other studies) and if not, why not.
This would enrich the  Discussion