Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

In general, authors must review the scientific level of the paper. My comments are:

 

·       The title should best express the objective of the study. Authors must use a word other than "Survey"

·       the subsections of the abstract should be clearer.

·       The introduction sentence of the abstract should be improved

·       The authors should specify in which sports this type of diet is carried out. And explain in more detail

·       The authors should also explain the benefits and dangers of these diets.

·       In line 101, the authors talk about validity; have they performed any kind of analysis to verify this?

·       Section 2.4 should be section 2.2.

·       Figure 1: It's a major error that there were 114 started and 173 completed. It's weird, isn't it?

·       It is a descriptive study only, right? There are no statistics of any kind. Section 2.5 needs to be modified.

·       The discussion should begin with the main finding of the study

·       The discussion is too extensive. The authors should focus on explaining their data along with the existing literature.

·       Authors must include a "Limitations" section within the discussion section.

·       Authors must include a "Clinical Application" section within the discussion section.

·       The conclusion should have a separate section. The conclusion must give a more concrete message. It must have an extension of 3 lines at most. It should well summarize the main finding of the study. 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

dietetics-3377120

Title-please change the title to be more specific, i.e., include the athletes descrption, e.g., A Survey of Intentional Weight Gain Strategies in Young adult athletic Individual

Most studies on weight management among athletes primarily focus on weight loss. Investigating intentional weight gain offers valuable insights into a frequently neglected aspect of this field.

Abstract

Please change „The purpose of this study was to investigate the self-reported nutrition- and exercise-related behaviors of athletic individuals aiming to gain weight.” to „This study aimed to investigate the self-reported nutrition- and exercise-related behaviors of athletic individuals aiming to gain weight.”

Please delete „from” in line 13.

Overall, the Abstract is informative and concise, making it a good abstract. The Abstract has clear objective and details its methodology, utilizing cross-sectional data from an online survey. It also presents the demographic characteristics of the participants involved. The findings reveal typical motivations behind weight gain, dietary approaches, and modifications in exercise habits, offering valuable insights for both researchers and practitioners in the field. Furthermore, it concludes by discussing the practical implications for professionals in nutrition and exercise, recommending ways to apply these findings in real-world contexts.

1. Introduction

 

This is oddly written; „Intentional weight gain strategies are employed by athletic individuals for a variety of reasons, which include aesthetics, perceived performance improvements (e.g. increased strength and power), and/or to better match their opponents’ size [1-3].” Please rewrite to have: „Athletic individuals often utilize intentional weight gain strategies for several reasons, including aesthetic goals, improved perceived performance such as enhanced strength and power, and the desire to match the size of their opponents”.Lines 26-28.

Please change: „Although many athletic individuals believe that increasing only protein intake leads to LBM gains, most nutrition experts recommend the energy surplus comprise mainly of CHO and protein [2, 5, 9, 10].” to „Although many athletic individuals believe that increasing protein intake leads to LBM gains, most nutrition experts recommend that the energy surplus comprise mainly CHO and protein [2, 5, 9, 10].” Lines 38-40.

Change „comprise” to „comprises” in line 40.

This is a long sentence: „All food groups may still be consumed at mealtimes, however, to increase energy intake the portion sizes of all food groups may need to be increased and/or energy-dense toppings, such as olive oil, cheese, avocado, nuts, and seeds, judiciously incorporated.” Please split to have 2 sentences: „All food groups may still be consumed at mealtimes. However, to increase energy intake, the portion sizes of all food groups may need to be increased and/or energy-dense toppings, such as olive oil, cheese, avocado, nuts, and seeds, judiciously incorporated.” Lines 41-43.

Please use a hyphen in „high energy” so it will be „high-energy” in line 55.

Remove „who are”, please. Line 57.

The use of commas and other grammar issues here: „Only a few published studies evaluated such weight gain practices by investigating the general eating habits of adolescent and young adults  via surveys or questionnaires [15-17], but none to our knowledge have been conducted in (or targeted) athletes.”. Please change to ” Only a few published studies evaluated such weight gain practices by investigating the general eating habits of adolescents and young adults via surveys or questionnaires [15-17], but none, to our knowledge, have been conducted in (or targeted) athletes.”
Lines 58-60.

This does not read well: „O’Dea and Rawstorne [17] and Woodruff et al. [16] found that 27.7% and 9%, respectively, of their study populations were currently attempting weight gain.” Please revise, perhaps the following will be acceptable by the Authors: „O’Dea and Rawstorne [17] reported that 27.7% of their study population was attempting weight gain, while Woodruff et al. [16] found that this figure was 9%”. Lines 61-62.

Please rewrite the following: „For example, many individuals may not know whether they are increasing CHO or protein or fully address a question asking about which macronutrient is increased.” If the Authors agree, plase change to : ”For example, many individuals may not know whether they are increasing CHO or protein or fully address a question about which macronutrient is increasing”. Lines 72-74.

Please replace „the design of” with „designing” in line 78.

Overall, the Introduction effectively describes the rationale for the work in the context of existing knowledge. The Introduction highlights the weight loss in research, especially among athletic populations, while acknowledging the scarcity of studies that explore intentional weight gain. The Introduction lists various reasons why athletes may pursue weight gain, including the enhancement of performance and the achievement of aesthetic objectives. Furthermore, it emphasizes the importance of gaining primarily lean body mass rather than fat mass.
However, please address the following:

1. The discussion of previous research predominantly centers on adolescents and young adults, which may limit the representation of the diverse range of athletic populations. This focus could restrict the generalizability of the findings to various age groups or types of athletes. I understand that the study recruits quite young participants (24±5 years) and this is why the mention of prior studies primarily focuses on adolescents and young adults. However, adding a few sentences regarding other ages, would show thinking "outside of the box".

2. To enhance the Introduction, it would be beneficial to include more concrete examples of the athletic populations being studied, such as the specific sports involved and the levels of competition. This addition would provide a clearer context for the findings and specify which athlete demographics are the subject of the research.

3. While the Introduction mentions that some might engage in unhealthy methods to gain weight, it would be helpful to expand on the health risks linked to these practices, like the use of anabolic steroids or an excessive dependence on dietary supplements.

4. In the last sentence ” Therefore, the aim of this research was to investigate the self-reported dietary intakes and  nutrition- and exercise-related behaviors of athletic individuals actively attempting weight gain” please , it would be beneficial for the Authors to provide more specific information regarding the demographics of the participants.

2. Materials and Methods

2.1. Study Procedures

The following does not sound right: „A short paragraph preceded the questionnaire which explained study aims and that: a) participation was voluntary, b) there wereno foreseeable risks, c) withdrawal from the survey was allowed at any point, d) responses  would be confidential, and e) survey completion implied consent.” Please change to: „A short paragraph preceded the questionnaire, which explained the study aims and that: a) participation was voluntary, b) there were no foreseeable risks, c) withdrawal from the survey was allowed at any point, d) responses would be confidential, and e) survey completion implied consent.”Lines 88-91.

2.2. Survey Development

Please delete „The creation of”. Replace it with „Creating”. Line 93.

Please replace „which” with „whom” in line 100.

Please insert a hyphnen in „weight gaining”’ so it should be „weight-gaining” in line 109.

This does not read well: „Height was reported in inches with conversion instructions for both American and International units. Weight responses were reported in pounds (lb) with conversion instructions from kilograms (kg).” Please rewrite to have :” Height was reported in inches with conversion instructions for American and International units. Weight responses were reported in pounds (lb) with kilograms (kg) conversion instructions.”Lines 112-115.

The following does not read well: „The survey did not contain any personally identifiable information and took approximately 10 minutes to complete.”. Please have the following instead: „The survey contained no personally identifiable information and took approximately 10 minutes to complete”. Lines 115-116.

2.3. Survey Distribution and Administration

Remove the comma after „listservs” in line 120, please.

Please replace „provided by” with „from” in line 123.

Rewrite: „Participants completed the survey using either a mobile phone or computer and were not allowed to take the survey more than once from the same device.” Please incorporate the following instead: „Participants completed the survey using either a mobile phone or a computer, and they were not permitted to take the survey more than once from either device”.

2.4. Participants

The following does not read well: „To be eligible, participants had to currently be on an athletic team, regularly playing a sport or training for an athletic activity, such as running  or cycling, in the military, or exercising at least four days per week.” Please rewrite: „To be eligible, participants had to be on an athletic team, regularly play a sport or train for an athletic activity like running or cycling, be in the military, or exercise at least four days per week.” Lines 130-132.

Please add a comma before „which was based” in line 136.

2.5. Descriptive and Summary Statistics

In the last sentence, please revise: „percentage of responses are reported”. It should be „the percentage of responses is reported”.

3. Results

Figure 1. Participant completion flow chart. The rule is that the caption should be under the figure, not above it. Please revise. Also, there is inconsistency in „n”. Sometimes, it is written in capitals in the figure and sometimes in lowercase. Please see the comment regarding "n," which appears in a few comments below.

Figure 2. Percentage of participant responses to current weight gain attempts (N=168). I suggest adding some information concerning statistics, e.g., standard deviation/mean/median, etc., in the caption. Please see the comment regarding "n," which appears in a few comments below.

Figure 3. Percentage of participant responses to the question, “Did you receive any advice on how 171 to gain weight?” (N=168). I suggest adding some information concerning statistics, e.g., standard deviation/mean/median, etc., in the caption. Please see the comment regarding "n," which appears in a few comments below.

Figure 4. Percentage of participant responses to the statement, “Please select all that apply if your 179 exercise habits changed to promote weight gain.” (N=168). I suggest adding some information concerning statistics, e.g., standard deviation/mean/median, etc., in the caption. Please see the comment regarding "n," which appears in a few comments below.

All Tables-I think that the number of participants etc. should be written n but italicized. For expamle, in Table 5 instead of „N”, there should be „n”. Please apply throughout the manuscript.

Please change „butters” to „butter” in 206 and 221.

Please add a hyphen in „full fat” so it should be „full-fat” in 221.

Table 1-what is ROTC?

4. Discussion

„half of participants”-line 232.  Please change to „half of the participants”.

„the majority” please change to „most” in line 235.

The following reads poorly: „Furthermore, in our study, 83.9% of participants reported increasing protein intake, which was similarly reported in previous studies [15, 17].” Please revise. Perhaps the Authors meant: „Furthermore, 83.9% of participants reported increasing protein intake in our study, which was similarly reported in previous studies [15, 17].”Lines 239-240.

„such as increase”-please change to „such as an increase” in line 257.

Please delete „of those” in line 268.

Line 294 „This may imply participants were actively engaged in this behavior prior to our study”. This must be rewritten to: „This may imply that participants had actively engaged in this behavior before our study.”

Lines 310-311. „Insufficient sleep may be detrimental to protein synthesis pathways [19] and hinder athletic performance, both physically and mentally [18, 41].” This must be rewritten to: „Insufficient sleep may be detrimental to protein synthesis pathways [19] and hinder physical and mental athletic performance [18, 41].”

„The strengths of our study include use of an online survey platform to reach a large  population of athletic individuals, as evident by our national and international reach (Table 1).” Rewrite please: „Our study's strengths include using an online survey platform to reach a large population of athletic individuals, as evident by our national and international reach (Table 1).”Lines 322-324.

Another strength includes our survey development methodology which consulted  with eight RDs and two survey design experts. Rewrite please:” Another strength is our survey development methodology, which consulted  eight RDs and two survey design experts.” Lines 324-325.

„The limitation of our study also includes  use of online survey data, which rely on self-report and honesty.” This does not read well. Please rewrite: „Our study's limitation also includes using online survey data, which rely on self-reporting and honesty” Lines 325-326.

The following does not read well: „Furthermore, it may have been valuable to understand how many participants were following vegetarian or vegan diets, which  potentially could be the reason for their difficulty in gaining healthy weight, as these diets  tend to be lower in energy and protein [42].” Please change to „Furthermore, it may have been valuable to understand how many participants followed vegetarian or vegan diets, which could be the reason for their difficulty in gaining healthy weight, as these diets tend to be lower in energy and protein [42].”Lines 332-335.

This study addresses a gap in knwoledge by examining weight gain behaviors in the context of athletics. It emphasizes prevalent strategies and underscores the necessity for evidence-based recommendations to mitigate possible health risks.

The Discussion is good. However, this section could be strengthened in 3 areas:

1) The Discussion currently depends heavily on cross-sectional data, which restricts the capacity to infer causal relationships between variables. It is essential to incorporate a longitudinal approach to strengthen the findings and provide more robust conclusions. Please just write that the cross-sectional approach could be extended by longitudinal (limitations of your study).

2) The study recognizes that male and female participants participate in weight gain practices. However, it could benefit from examining  the potential differences in motivations and strategies related to gender. Please just write under the limitations of the current study.

3) The Authors state that 9.6% of participants reported using anabolic hormones. Discussing the effects of extreme methods would highlight the significance of safe and sustainable strategies for gaining weight.

The work's overall merit is currently average, primarily due to its writing style. However, by addressing the comments, the Authors have a great opportunity to enhance the rating significantly. Effectively conveying the work's value is essential, as strong communication can greatly aid in its success.

Comments on the Quality of English Language

I believe that the language could be enhanced. I have outlined the necessary changes and indicated the specific areas where these revisions should be made.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

While the manuscript addresses a relevant and timely topic in sports nutrition and exercise science, several limitations need to be addressed before it can be considered for publication. To enhance the manuscript, it is essential to define the target demographic of athletes clearly. By focusing on specific subgroups, such as those engaged in weight-sensitive activities like combat sports or those pursuing particular aesthetic goals, the text can provide valuable insights for professionals who train various athletes.

Moreover, the health risks and ethical concerns surrounding the use of anabolic steroids and similar substances must be explored more deeply. While the current version briefly addresses this issue, a thorough examination of potential health threats and an exploration of ethical implications would significantly elevate the quality of the paper.

Methodological transparency should also be prioritized. Expanding on the design and validation of the survey is essential, especially concerning strategies implemented to mitigate biases associated with self-reported data and detailing the validation process of the survey instrument. This is particularly critical since self-reported data is often prone to bias.

Although the results are presented clearly, a more extensive discussion of their implications would be beneficial. It is crucial to carefully assess the study's limitations, notably the lack of diversity in the types of sports represented. Additionally, drawing parallels between the findings and previous research on athletes' intentional weight gain strategies could enrich the narrative.

The conclusions should more accurately represent the complexities and limitations encountered during the study. It would also be helpful to discuss potential avenues for future research, mainly focusing on the long-term consequences of strategies for intentional weight gain.

Comments on the Quality of English Language

The language in the manuscript should be more precise and concise to improve readability. Some sections, particularly the introduction and conclusion, contain overly complex or vague phrasing that could be simplified to improve engagement.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The authors responded to my comments appropriately

Author Response

Thank you, and thank you again for your thorough review of our manuscript. 

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

I appreciate the Authors effort to improve the manuscript and enjoyed the rebuttal letter. I recommend minor revisions now.

Introduction

Please replace „the design of” with „designing” in line 78.

Author: We have made the requested edit.

Round 2 Reviewer: This has not been addressed, it still exists in line 80, but OK, this can be ignored.

2. To enhance the Introduction, it would be beneficial to include more concrete examples of the athletic populations being studied, such as the specific sports involved and the levels of competition. This addition would provide a clearer context for the findings and specify which athlete demographics are the subject of the research.

Author: Thank you for this comment. We added, “Athletic individuals often utilize intentional weight gain strategies for several reasons, including aesthetic goals, perceived performance improvements such as enhanced strength and power, and the desire to match the size of their opponents [1-3]. Examples include sprinting, discus, shot-put, football, rugby, and ice hockey.” Furthermore, our Table 2 gives an extensive list of the many sports in which our participants were engaged to provide more examples.

Round 2 Reviewer: No. This was in version number 1: „Athletic individuals often utilize intentional weight gain strategies for several reasons, including aesthetic goals, perceived performance improvements such as enhanced strength and power, and the desire to match the size of their opponents [1-3].” But I agree that Table 2 gives an extensive list of the many sports, so I accept this.

Figure 3. Percentage of participant responses to the question, “Did you receive any advice on how 171 to gain weight?” (N=168). I suggest adding some information concerning statistics, e.g., standard deviation/mean/median, etc., in the caption. Please see the comment regarding "n," which appears in a few comments below.

Author: We have made the requested change. We have followed the rule that capital N refers to our whole sample size, and lowercase n refers to subsets. We have made sure this is consistent throughout.

Round 2 Reviewer:The Authors have added „Mean±SD responses = 8.74±4.34.” in lines 178-179. Does this apply to Figure 3? If yes-then this information should go to the Figure 2 caption.

Figure 4. Percentage of participant responses to the statement, “Please select all that apply if your 179 exercise habits changed to promote weight gain.” (N=168). I suggest adding some information concerning statistics, e.g., standard deviation/mean/median, etc., in the caption. Please see the comment regarding "n," which appears in a few comments below.

Author: We have made the requested change. We have followed the rule that capital N refers to our whole sample size, and lowercase n refers to subsets. We have made sure this is consistent throughout.

Round 2 Reviewer: The Authors have written „Mean±SD responses = 4.11±2.83” in line 186. Shouldn’t it be in the Figure 2 caption?

Author Response

Please see the attachment. 

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The authors have addressed some of the concerns raised in the review; however, several issues remain only partially resolved or insufficiently justified. Below is a detailed assessment of their responses.

Regarding the target athlete population, the authors argue that weight gain is relevant across all sports and provide examples in the introduction. While this addition is valuable, it does not fully address the concerns related to weight-sensitive sports. The study does not analyze athletes who are more likely to manipulate their weight for competition, such as those in combat sports or weightlifting. Including a subgroup analysis or explicitly acknowledging this limitation would strengthen the manuscript.

Concerning the discussion of anabolic steroid use, the authors have added a brief examination of the risks associated with anabolic steroid use and emphasized the need for education. This addition is an improvement, but it remains superficial. A more in-depth discussion of the ethical concerns, regulatory implications, and potential motivations for use (such as pressures in weight-class sports) would enhance the manuscript.

The authors contend that survey methodology is a preliminary step in survey design and validation, and they acknowledge that self-reported data is a limitation regardless of the mode of administration. They have included a statement in the limitations section about self-report bias. However, this response does not adequately address the issue of survey validation. While self-reported data is inherently biased, discussing reliability measures (such as pilot testing and internal consistency analysis) would improve the study’s credibility.

Regarding the discussion of findings and comparison with existing literature, the authors indicate that another reviewer requested a reduction in discussion length and believe they have sufficiently compared their findings to previous research. Although the study references past research, there is no detailed comparison of key trends, discrepancies, or new insights. A stronger connection between the findings and prior literature would enhance scientific rigor.

Finally, in terms of conclusions and future research, the authors have added limitations and retained their original statements about future research. While the constraints are now better addressed, the future research section remains vague. A more concrete discussion of potential study designs (such as longitudinal studies or controlled interventions) would strengthen the conclusions.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 3

Reviewer 2 Report

Comments and Suggestions for Authors

I accept the manuscript in its current form.

Comments for author File: Comments.pdf