Title: Dealing with lipoedema: women’s experiences of healthcare, self-care, and treatments—
a mixed-methods study
Version: 0 Date: 31 Jan 2025
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses a testable research
question(s) (brief or other article types: is there a clear objective)?
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with technical rigor to allow
confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
Yes - appropriate statistical analyses have been used in the study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work technically
sound? If not, can revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: Thank you for the opportunity to review this paper. This study
presents a national mixed-methods investigation, incorporating both quantitative and qualitative
findings, to explore the use and self-reported effects of self-care approaches and lipoedema
treatments, as well as the perceptions of women with lipoedema regarding their healthcare
experiences. The topic is interesting and important, particularly given the limited research
focused on women with lipoedema. The study approach is appropriate for addressing the
research questions, and the paper is generally well written. However, I found the manuscript
somewhat lengthy, making it challenging to follow. Below are specific comments for the authors
to consider:
1. Abstract:
Methods: Pls specify the time frame during which the survey was conducted.
Results: Consider including key statistical findings from the quantitative survey to provide
clearer insights.
2. Background:
This section is somewhat lengthy and could be more concise.
(1) Some statements lack references, such as the description of lipoedema types and stages,
as well as the claim that "some approaches and treatments have shown promising results in
reducing lipoedema symptoms, improving quality of life, and preventing disease progression."
Pls provide supporting citations.
(2) Consider rewording the sentence: "Given the variations in disease development and clinical
presentation, measures of functioning, limitations in daily activities, and health-related quality
of life should be evaluated repeatedly to meet and support individual needs and enhance suitable
treatments (23)." Suggested revision: "Given the variations in disease progression and clinical
presentation, it is essential to regularly assess functioning, limitations in daily activities, and
health-related quality of life to address individual needs and optimize treatment strategies (23)."
3. Methods:
(1) Participants and Setting: How did the authors ensure that women with cognitive impairment
were excluded? (2) The sample of 700 members included women with lipoedema, support
members, and healthcare providers. Can you provide the approximate total number of women
with lipoedema in the group? This would help contextualize the 245 women surveyed as a
proportion of the total. (3) The "Measurement and Data Collection" section could be split into
two separate subsections: One focusing on "Measurements" and Another detailing the "Data
Collection Procedure". In addtion, to improve clarity, consider including the developed survey as
an appendix and providing a more concise description in the main text, as the current explanation
is somewhat lengthy. (4) Please specify how many participants responded to the qualitative
questions.
4. Results: The quantitative findings are primarily descriptive, and the authors have effectively
presented them in tables and figures. Where possible, please streamline the main text to make
it more concise and easier to follow.
5. Discussion: The discussion is comprehensive, but a more concise version would enhance
readability and help readers grasp the key points more efficiently.
REQUESTED REVISIONS:
Minor revision