Reviewer's report
Title:A Prospective study of the association between weight changes and
self-rated health
Version: 4Date:22 June 2008
Reviewer: Yael Benyamini
Reviewer's report:
Major Compulsory Revisions
Though the manuscript is again much improved, the hypotheses and main
findings are still difficult to follow. Re-wording the last paragraph of the
introduction and the first paragraph of the discussion could solve this problem
and make it easier for the reader to understand what was tested and what was
found.
Page 20, last paragraph of the introduction section: There seems to be some
redundancy in this paragraph yet with more careful reading the hypotheses
described in the first part are not the same as those described later in the
paragraph: (a) Do you hypothesize that overweight women who become normal
weight will rate their health better [at follow-up] than women who were constantly
overweight or will show an increase in health ratings? These are not necessarily
the same phenomena; (b) Do you expect individuals with poor SRH at baseline
to have "an increased risk of being obese later in life" or expect poor SRH at
baseline "to lower the odds of gaining weight"?
[In addition, "we have the hypotheses" should be replaced by better wording in
English (or omitted, as part of taking care of the redundancy in the paragraph).]
The discussion section could benefit from a clearer summary and discussion of
the main findings presented hypothesis by hypothesis, stating in each case what
has been supported and what has not. The first paragraph in particular must be
re-worded.
Page 25, the sentence "Participants experienced a decrease in SRH when they
either gained or lost weight": Does this refer to the findings reported in Table 4?
The odds ratios in that table for those who lost weight were non-significant.
Similarly, the second sentence of the conclusions section should correspond with
the findings.
Page 26, sentence which begins on line 5 - "Depressed mood..." - this sentence
should be omitted or more clearly tied to the findings and the explanations
provided for them. As is, it is unclear.
Page 26, beginning of the last paragraph - "We really still do not know what we
measure" - regarding what construct?
Middle of page 28 - though regression to the mean can certainly occur with such
data, the problem described results not from regression to the mean but from
floor and ceiling effects (regression to the mean would increase the likelihood
that women who rated their health very poor in 1993 would rate it less poor in
1999 yet the sentence reads: "Individuals rating their health very poor in 1993
and rate their health even poorer in 1999 will not be recorded" (please also
change 'rate' to 'rating').
Minor Essential Revisions
Although the authors have indicated that they asked a native English speaker to
go over the manuscript, there are still quite a few errors, which must be
corrected.
Page 19, line 6 - "re-ejection" - did you mean rejection?
Page 19, line 13 - 'and' instead of 'but' or split into two sentences.
Page 19, six lines from bottom - add hyphen after health (health-related quality of
life). Similarly, add hyphens in the same expression in several places on page
26.
Page 21, line 9 - 'age' and not 'aged'.
Next line - 'between' instead of 'among' (the sentence refers to a comparison
between two groups).
Page 23, first line of the statistical analyses section - add 'logistic' (multivariate
logistic regression analysis).
Page 24, first paragraph of the results section - "41% changed rating" is the
same as "59% experienced no change in self-rated health", which appears two
sentences later.
Please be consistent in using SRH or self-rated health.
Page 24, last sentence of the first paragraph - twenty-three (with a hyphen).
Page 25, line 5 of the discussion - 'period' without an 'e' at the end of the word.
Next sentence - 'fair' instead of 'fairly'.
Page 26, line 4 - "One of the conclusions of this study" (instead of 'in this paper').
Two sentences later - "The results from the current study" - use 'current' instead
of 'this' so there will be no confusion with the study cited in the previous
sentence.
Page 27 - "...which raises a question regarding validity." ('regarding' instead of
'on'.
Page 28, 7 lines from bottom - "This" instead of "thus".
Page 28, two sentences later ("Identical problems occur...") repeats what has
been said just a few sentences earlier.
Page 29, first sentence - in "summary" (with an 'a').
Table 5 - 'fair' and not 'fairly'.
Discretionary Revisions
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.