Reviewer's report
Title:Experiences of Barriers and Facilitators to Weight Loss in a Diet
Intervention - a Qualitative Study of Women in Northern Sweden
Version:2Date:23 October 2013
Reviewer: Jennifer D. Irwin
Reviewer's report:
This manuscript represents an interesting focus pertaining to intervention
participants’ experiences of barriers and facilitators to weight loss when following
a diet change. The following review is intended to help the authors increase the
clarity of their work and more strongly underscore the importance of considering
factors underlying the process of body composition changes among women
struggling with overweight or obesity. Using the guide provided for reviewers, the
following compulsory revisions are recommended prior to the manuscript being
ready for publication.
1. Are the methods appropriate and well described?
Qualitative methods are appropriate to answer the stated purpose. However,
information is currently missing to fully understand what the researchers actually
did. Qualitative research is to be rich with thick description. Information that is
currently absent includes:
• What as the content of the intervention?
• Why were the women put into two separate arms of the intervention when the
authors do not analyse the data by group, nor does group allocation seem to
have any relevance to the purpose statement of the study?
• Because the authors overtly note that this was an intervention study, more
information about the content of the intervention is required (such as what topics
were covered during the lectures, who led the sessions, how were each group
taught about their particular intervention, which sources were used to guide each
intervention – none are currently referenced, etc).
• What was done to help ensure data trustworthiness during the interviews
themselves? In the discussion the terms ‘credibility’ and ‘transferability’ are
noted, but without any explanation as to what was done to help facilitate these.
No sources/references are provided for trustworthiness concept (it is curious that
no quotes were provided, as this is a key component of ensuring the ‘credibility’
of findings presented)
• What were the questions actually asked (or a few samples) in the interviews?
• How did the researchers decide on the number of participants? Was saturation
reached?
• How many participants dropped out from each intervention and were the
numbers statistically significant between the two groups?
• What was the study finding related to weight loss, and particularly between the
two groups (this information would help to contextualize the findings)?
2. Are the data sound?
The information corresponding to the questions above will be required to
determine the soundness of the data
3. Does the manuscript adhere to the relevant standards for reporting and data
deposition?
Not currently, but if the authors are able to attend to the
questions/concern/feedback raised above, this could be resolved.
4. Are the discussion and conclusions well balanced and adequately supported
by the data?
The discussion is fairly well done, although it could benefit substantially by
viewing and integrating literature that has looked (qualitatively) at the
experiences of being obese, and the challenges of reducing body mass. This
paper would benefit from a deeper look at this literature, rather than limiting its
scope to integrating only those studies that have looked at challenges of sticking
to a diet change (given that recent research has found that often, the behaviours
of obesity can be symptoms of the individual’s relationship with herself, and if
that relationship is not explored, long-term weight loss is not a reasonable
expectation of a diet-change-only intervention).
A ‘limitations of the research’ section needs to be expanded upon in the
manuscript.
7. Do the authors clearly acknowledge any work upon which they are building,
both published and unpublished? Not that I noticed although it would make sense
that this study is in addition to a quantitative study that would have been done to
compare the group allocation findings related to weight loss (it seems very
curious that the authors studied two intervention groups but analysed them
together) .
Level of interest: An article whose findings are important to those with closely
related research interests
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'