A Systematic Review of Moderators of the Association between Dietary Restraint and Binge Eating
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsThere are cardinal limitations to the methodology of the manusript.
1. Sample Diversity: The reviewed studies predominantly involved heterosexual White college female students, which significantly limits the generalizability of the findings. Future research should aim to obtain more diverse sample representations.
2. Study Design: Most of the studies included in the review were cross-sectional and relied on self-report measures. This limits their ability to infer causality and may introduce biases related to self-reporting.
3. Moderator Identification: The Moderators were consistently identified across the studies. This inconsistency might reflect the complexity of the relationship between dietary restraint and binge eating but also suggests that future studies should employ more standardized methods to identify and test potential moderators.
4. Measurements of Restraint: The studies used a variety of measures to assess dietary restraint, which might have conceptual differences (e.g., flexible vs. rigid restraint). This variability could affect the consistency of findings across studies and suggests a need for more rigorous assessment tools.
Data and Analysis Evaluation
5. This systematic review compiled data from 16 articles, including diverse sample characteristics, measures of dietary restraint/restriction, binge eating, and the moderators examined. The data extraction process was thorough, with details on the sample size, characteristics, measures used, and findings regarding moderation, which allowed for a comprehensive analysis of the evidence.
However, the variability in the measures of restraint and binge eating across studies poses a challenge to the synthesis of these findings. Moreover, reliance on self-report measures may have introduced bias. The analysis noted no consistent evidence for any single moderator across the studies, which may reflect heterogeneity in the measures and study designs.
Conclusions Validity
6. The study concludes that there is a need for further research to clarify and validate moderators of the dietary restraint-binge eating relationship and to understand the complex interactions and potential causal relationships. This conclusion is valid, given the methodological limitations and heterogeneity of the included studies. Recommendations for more diverse methodological approaches and the examination of different conceptualizations of restraint are well founded.
7. The highlighted limitations and recommendations for future research underscore the need for more standardized and comprehensive approaches to further elucidate these relationships.
8. Incorporating more comprehensive reviews or meta-analytic findings could strengthen the discussion by providing aggregated insights into the effectiveness of interventions and the robustness of identified moderators.
Comments on the Quality of English Languageminor changes
Author Response
Please see the attachment.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsThis is a very interesting manuscript that aims to identify moderators of the link between dietary restraint and binge eating. The Introduction part with the state of art and the rationale of the study is accurate, the Methods are precisely described, the Results are clearly presented and final paragraph with conclusions support the study results.
My main suggestions relate to the Discussion part:
Lines 111-121 - Different tools and definitions of dietary restraint should be more thoroughly discussed. This aspect seems to greatly affect the study results. You have mentioned the examples of differences between EDEQ and TFEQ. I suggest that you discuss also other questionnaires used in the studies included in your systematic review, e.g. DEBQ, flexible and rigid CR scales etc., how dietary restraint concept vary between them and how it may explain the link between dietary restraint and binge eating. Perhaps, the following reference will also be useful in the discussion: Polivy, J., Herman, C. P., & Mills, J. S. (2020). What is restrained eating and how do we identify it?. Appetite, 155, 104820. https://doi.org/10.1016/j.appet.2020.104820.
Other minor issues:
Numbering of the lines in the manuscript starts all over again from the page 11 just below the figure.
Figure 1 'Records excluded' -> ‘Non-human’ is underlined
Table 1 ‘ Sehm & Warschburger, (2015)’ – the second column, i.e. sample recruited, is blank
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
Reviewer 3 Report
Comments and Suggestions for AuthorsA reviewed article titled „A Systematic Review of Moderators of the Association between Dietary Restraint and Binge Eating” is very well prepared in terms of content and editing. The considerations are carried out in a transparent way, divided into different groups of factors that may be moderators of the relationship between restrained and binge eating. The article contains many valuable tips for researchers dealing with this issue which perfectly guides future research.
However, I have two specific comments, namely the text (lines 30-31) should be omitted. Moreover, in my opinion, there could be more current literature references in the introduction.
Comments for author File: Comments.pdf
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for Authors1. The studies included in the review predominantly featured specific demographics (heterosexual white female college students), which limited the generalizability of the findings.
2. Considerable variability exists in how dietary restraint and binge eating are measured across studies, which may affect the consistency and comparability of the results.
3. Most studies are cross-sectional, which restricts insight into the causality and dynamics of the relationships between dietary restraint, binge eating, and their moderators.
4. The manuscript does not explain the different measures used for dietary restraint and binge eating to help readers understand the potential implications of these findings.
5. The discussion has great limitations related to the homogeneity of samples and measurement issues, proposing specific future research directions to address these gaps and have to be addressed. It does not meet the criteria for a review of the literature.
Comments on the Quality of English LanguageThe manuscript does not meet the criteria for a systemic review
Author Response
- The studies included in the review predominantly featured specific demographics (heterosexual white female college students), which limited the generalizability of the findings.
- Considerable variability exists in how dietary restraint and binge eating are measured across studies, which may affect the consistency and comparability of the results.
- Most studies are cross-sectional, which restricts insight into the causality and dynamics of the relationships between dietary restraint, binge eating, and their moderators.
Response: These are excellent points. We address these points in the Discussion section. We hope that our review shines a light on these limitations and spurs new research.
- The manuscript does not explain the different measures used for dietary restraint and binge eating to help readers understand the potential implications of these findings.
Response: We now indicate the different measures used in the reviewed studies on Pages 5-6: “There was a great deal of variability in measure of restraint used, with most studies using the Eating Disorder Examination Questionnaire (k=5), Restraint Scale (k=3), a combined or study developed scale (k=3), Dutch Eating Behavior Questionnaire (k=2), or Dietary Intent Scale (k=2); the following scales were used in single studies: Three Factor Eating Questionnaire Eating Inventory, Cognitive Restraint Scale, and Eating Pathology Symptoms Inventory. Similarly, there was variability for binge eating measures, with most studies using the Eating Disorder Examination Questionnaire (k=3), Revised Bulimia Test (k=3), Minnesota Eating Behavior Scale (k=3), or a combined or study developed scale (k=3); the following scales were used in single studies: Binge Scale, Binge Eating Scale, Eating Disorder Inventory, and Eating Pathology Symptoms Inventory.”
We also mention differences between restraint s and binge eating cales in the Discussion on Pages 9-10. We do not go into every scale as there are many different scales and this is outside the scope of the study.
“Measures of dietary restraint differed across studies, which may be of concern given differences in conceptualization and foci of varying measures of restraint (e.g., flexible vs. rigid restraint). For example, the Eating Disorder Examination Questionnaire Restraint subscale focuses on rigid forms of restraint such as strict food rules, limiting to influence shape/weight, and food exclusion [37] whereas the Three Factor Eating Questionnaire Cognitive Restraint subscale and Dutch Eating Behavior Questionnaire focus primarily on portion control and eating less [38-39]. Due to varying conceptualizations of dietary restraint [40-41], different forms of restraint may dissimilarly interact with other variables to predict binge eating, necessitating improved and rigorous assessment of dietary restraint in future research. Recently, Polivy and colleagues [40] similarly concluded the need for carefully defining dietary restraint constructs and research questions to ensure accurate measurement of dietary restraint and to be able to understand how different restraint constructs are associated with outcomes of interest. Similarly, measures of binge eating varied across studies. Binge eating measures differ in examining frequency of episodes vs severity of symptoms as well as focus on behavioral symptoms (e.g., overeating, loss of control) and/or associated psychological features (e.g., guilt, shame). Choice of measure may affect findings and should be chosen in alignment with research question and theoretical framework.”
- The discussion has great limitations related to the homogeneity of samples and measurement issues, proposing specific future research directions to address these gaps and have to be addressed. It does not meet the criteria for a review of the literature.
Response: Thank you for this comment. We believe our review does meet criteria for a systematic review as we followed the PRISMA guidelines for completing a systematic review.
Reviewer 2 Report
Comments and Suggestions for AuthorsThe changes have improved the manuscript.
Author Response
Thank you, we are glad our changes have improved the manuscript.
