Sugar Substitutes Can Help Maintain Weight Loss Without Raising Disease Risk

People concerned about their weight often turn to artificially sweetened products for a no- or low-calorie sweet fix, but does the strategy really help with weight management?

A new study suggests it could be promising. The research, known as the Sweet Project, found that people who had rapidly lost weight and then replaced sugary foods and drinks with those containing sweeteners and sweetness enhancers (S&SE) continued to lose weight for a year.

Researchers, who will present their findings at the European Congress on Obesity in May, also discovered a link between sweetener consumption and enhanced mood, increased diet satisfaction, and reduced cravings for sweets.

Furthermore, ingesting sugar alternatives didn’t appear to increase the risk of type 2 diabetes or heart disease.

The findings contrast with a 2023 World Health Organization (WHO) systematic review concluding that artificial sweeteners do raise the odds of developing those chronic conditions and that replacing sugary products with artificially sweetened ones doesn’t help with long-term weight control. Based on its research, the agency recommended against consuming artificial sweeteners for weight loss.

Anne Raben, PhD, a professor in the University of Copenhagen’s nutrition department who led the new study, said in a statement that “weight maintenance after weight loss is difficult to achieve, and our findings support the use of S&SEs found in many foods and beverages worldwide as alternatives to sugar-sweetened products to help manage weight control in adults with overweight.”

Here’s what else you need to know about replacing sugar with sweeteners as a weight loss strategy and if these products are safe to consume.

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For the one-year trial, researchers recruited nearly 350 adults who were overweight or obese, as well as almost 40 children considered overweight. 

During the first two months of the study, the team instructed the adult participants to follow a low-calorie diet aimed at helping them lose at least 5% of their weight. They told the children participants to maintain their weight.   

Then, they divided participants into two groups. One group followed a nutritious diet with less than 10% of calories coming from foods and drinks with added sugar, which couldn’t include products with artificial sweeteners. The other group followed the same eating plan, but they were allowed to consume artificially sweetened products. 

During the study, the participants completed questionnaires about their diet, eating habits, physical activity, and quality of life. Researchers also tracked their weight, body measurements, and markers for diabetes and heart disease.   

After ten months, the scientists found that adults in the sweetener-consuming group lost weight, were more satisfied with their diet, had a more positive mood, and had fewer cravings than participants in the other group. Adults in the group that couldn’t consume sweeteners also lost weight, but not quite as much as their sweetener-ingesting counterparts.

“The use of low-calorie sweeteners in weight management has been questioned, in part because of the link between their use and apparent weight gain in observational studies,” co-author Jason Halford, PhD, head of the University of Leeds’s School of Psychology and president of the European Association for the Study of Obesity, said in the statement. “However, increasingly it is becoming apparent that is not the case in long-term studies.”

The only finding for children participants was that replacing sugary food and drinks with sweetened products was beneficial for children with high levels of uncontrolled eating.

The analysis didn’t show a heightened risk of diabetes or heart disease in either group.

Researchers noted some limitations of the study, including the small number of children participating and the testing of sweeteners collectively without distinguishing between individual types. There’s also a question about the generalizability of the findings because most participants were women with higher education levels.

Previous studies have suggested that fake sugars could cause cardiovascular problems and diabetes. While researchers don’t know how this might happen, some people think they might stimulate sugar cravings or change the gut microbiome in a way that negatively impacts metabolism, Rekha Kumar, MD, an endocrinologist and former American Board of Obesity Medicine medical director, told Health

In the statement, Raben, who led the study, noted that most of the research into the safety of sweeteners has come from animal studies using doses far above the usual intake in humans. 

Despite the WHO’s recommendation, the United States Department of Agriculture hasn’t changed its stance on sweeteners. The agency has found that sweeteners are generally recognized as safe, or GRAS, Sarah Hormachea, MS, RD, a registered dietitian at Nourish, told Health

Experts interviewed agree that, at this point, the benefits of sugar substitutes outweigh any potential downside. 

“There are many more health risks associated with being overweight or obese than there are with consuming artificial sweeteners,” Kylie Bensley, MS, RD, a registered dietitian and owner of Suluni Nutrition, told Health. “If temporarily substituting sugar-sweetened food and beverages helps a person lose weight, that is preferable.”

Kumar said that managing or losing weight is not a one-size-fits-all process. It requires a “personalized, holistic approach,” she noted. Still, she pointed to strategies that can consistently support metabolic health. 

She suggests aiming for at least 150 weekly minutes of moderately intense physical activity, such as biking or brisk walking. 

You also want to understand how many calories and carbohydrates you need daily, depending on your body and lifestyle, and then be mindful of how much you consume.

Lauri Wright, PhD, RDN, a registered dietitian and associate professor with the University of South Florida College of Public Health, suggests eating a plant-forward diet filled with lean proteins, a wide variety of fruits, vegetables, whole grains, and healthy fats from foods such as nuts, seeds, olive oil, and fatty fish. She also recommends avoiding ultra-processed foods.

Finally, Bensley suggests developing easy ways to satisfy your sweet tooth through natural sugars. She’s a big fan of apple slices with caramel or a “Reese’s” apple with peanut butter and chocolate chips. 

“In my family, we satisfy our sweet tooth by stating we can have a sweet food once daily,” she said.

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