Do artificial sweeteners cause weight gain?
Short answer
Trials say no; population studies disagree.
In trials, people given sweeteners gained no more weight than with water, and usually less than with sugar. Population studies point both ways and show links, not causes.
This page says what the research shows. It does not say whether you should use artificial sweeteners.
Where the evidence stands
Each dot is one on-topic paper. Steps near the top answer the question more directly. Select a dot to see the study.
↑ Stronger evidence
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Trials in people: body weight
Trials that measured body weight and metabolic health directly.
4 -
Trials in people: other measures
Trials that measured other health or performance measures.
0None among the papers we read.
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Trials in people: lab tests or safety
Trials that measured lab tests, side effects or safety.
7 -
Population studies
Studies that followed or surveyed groups of people. They show links, not causes.
5 -
Blood levels and genes
Studies that link blood levels or genes to health.
1
↓ Weaker evidence
- Points to benefit
- Mixed
- No difference
- No direction
- Points to harm
Not on the ladder: 10 reviews of many studies (shown below), 5 opinion or narrative papers. Counts are papers, not people. Some studies appear in more than one paper.
See every studyWhat we found
- In a 1-year trial of 303 adults in a weight loss program, the diet drink group kept off 6.21 ± 7.65 kg, the water group 2.45 ± 5.59 kg. Peters 2016
- Pooling 7 trials found no clear effect of sweeteners on BMI (mean difference -0.37 kg/m2), while 30 population studies linked sweetener use to a modest rise in BMI. Azad 2017
- In a 12-week trial, sugar and saccharin drinks raised weight (+1.85 ± 0.36 kg and +1.18 ± 0.36 kg); aspartame, sucralose and rebaudioside A drinks did not. Higgins 2019
- Population studies split: older sweetener users had 0.80 kg/m2 higher BMI over a median 10 years, but among 143,409 US adults, more diet drinks went with slightly less weight gain. Chia 2016, Espinosa 2026
What the research says
Against water, diet drinks did not add weight
Four trials compared diet drinks or sweetened water with water or unsweetened drinks. None found more weight gain with sweeteners. In a 1-year weight loss program, people given diet drinks kept off more weight than people given water (6.21 ± 7.65 kg versus 2.45 ± 5.59 kg).
In 179 adults with type 2 diabetes who already drank diet drinks, switching to water for 24 weeks did not change weight. Their HbA1c, a long-term blood sugar test, came out 0.29% higher than in the diet drink group. Trials of 4 and 12 weeks found no clear weight difference.
Studies: Peters 2016, Odegaard 2026, Orku 2023, Ismail 2025
Against sugar, sweeteners mostly meant less gain
When sweeteners replaced sugar, BMI usually rose less. Reviews in children and teens found less BMI gain with sweeteners than sugar (mean difference = -0.114 kg/m2 in 4 trials; BMI z score -0.15 in another review). A 4-week stevia trial found BMI rose 0.3 kg/m2 more with sugar.
Sweeteners did not all act alike. In a 12-week trial, sugar drinks with 400-560 kcal a day raised weight by +1.85 ± 0.36 kg and saccharin drinks by +1.18 ± 0.36 kg. Aspartame, sucralose and rebaudioside A drinks did not change weight.
Studies: Espinosa 2024, Toews 2019, Kwok 2024, Higgins 2019
Many population studies link sweeteners to more weight
Many population studies link sweetener use to higher weight. Older adults who used sweeteners had 0.80 kg/m2 higher BMI and 53% higher incidence of belly obesity over a median 10 years. Across 3 studies, diet soda drinkers had 1.59 times the risk of obesity of non-soda drinkers.
A review of 11 pooled analyses linked diet drinks to obesity and type 2 diabetes. These are links, not proof of cause: weight may shape sweetener use. Authors of a study of 500 Dutch children said their urine sweetener links likely reflect diets that differ by weight.
Studies: Chia 2016, Ruanpeng 2017, Diaz 2023, Cai 2025, Azad 2017
A 28-year cohort points the other way
In 143,409 US adults followed a median 28 years, each extra 3 diet drinks a week went with -0.18 kg weight change over 4 years, meaning slightly less gain. Swapping 3 weekly sugary drinks for diet drinks went with -1.39 kg, the same as swapping to water.
In children, 8 cohort studies found no clear link between diet drinks and BMI gain (0.05 kg/m2 per daily serving, with a range from -0.03 to 0.13 that includes no effect).
Studies: Espinosa 2026, Espinosa 2024
Blood sugar results are mostly neutral
Most trials found no rise in blood sugar. A pooled analysis of twenty-nine trials with 741 people found sweeteners did not raise blood sugar. Trials of 2 and 4 weeks in healthy adults found no change in blood sugar, insulin or insulin sensitivity.
Some small lab studies differ: sucralose with a carbohydrate for 10 days lowered insulin sensitivity, and one sucralose drink raised blood sugar in a sugar test by 30 ± 10%. In 36,608 Australians, daily diet drinks were linked to 1.38 times the rate of type 2 diabetes.
Studies: Nichol 2018, Ahmad 2020, Orku 2023, Dalenberg 2020, Nichol 2019, Kabthymer 2025
What reviews of many studies found
Reviews pool or sum up earlier studies. They are not on the ladder, because they repeat studies already counted there.
Systematic review · Diaz 2023
Umbrella review of 11 pooled analyses from 7 reviews (51 cohort and 4 case-control studies). Diet drinks were linked to higher risk of obesity, type 2 diabetes, high blood pressure and heart disease. Only observational studies, so links, not causes.
Pooled review (meta-analysis) · Espinosa 2024
Pooled 4 trials (1372 children and teens) and 8 cohort studies (35,340). Trials: less BMI gain with diet drinks than sugary drinks (-0.114 kg/m2). Cohorts: no clear link. No study compared diet drinks with water.
Pooled review (meta-analysis) · Toews 2019
Pooled 56 studies, 35 of them observational. Very low to low certainty evidence showed a small BMI drop in adults (-0.6, two studies, n=174) and less BMI z score gain in children versus sugar. Most outcomes showed no difference.
Pooled review (meta-analysis) · Azad 2017
Pooled 7 trials (1003 people, median 6 months) and 30 cohorts (405 907 people, median 10 years). Trials: no clear BMI effect. Cohorts: sweetener use linked to higher BMI, weight, waist size, obesity and type 2 diabetes.
How the research grew
The papers we read span 2016 to 2026. 10 of the 32 on-topic papers came out in 2024 to 2026. The earliest trial in people here is from 2016.
- 2016
- 2017
- 2018
- 2019
- 2020
- 2022
- 2023
- 2024
- 2025
- 2026
Each dot is one on-topic paper, colored by what it found. Rings mark key papers:
- 2016. Largest trial here: diet drinks versus water, 1 year. Peters 2016
- 2017. Review shows trials and population studies disagree. Azad 2017
- 2019. WHO-supported review finds few clear effects. Toews 2019
- 2019. Trial shows sweeteners differ; saccharin raised weight. Higgins 2019
- 2026. 28-year cohort links more diet drinks to less gain. Espinosa 2026
Who was studied
Who took part, and how many. The largest trial here had 303 people; the largest population study had 351,805.
- Trials in people
- 303 people · Peters 2016
303 weight-stable adults with overweight or obesity, in a weight loss program - 46 people · Ismail 2025
46 children and young people aged 10 to 21 with obesity and prediabetes, all taking metformin - 42 people · Orku 2023
42 healthy young women with normal blood sugar who did not usually use sweeteners - Population, blood and gene studies
- People in the study, log scale1101001,00010,000100,0001,000,000
- Points to benefit
- Mixed
- No difference
- No direction
- Points to harm
Bars use a log scale: each step is ten times more people. Reviews, animal studies and papers with no count in the abstract are not shown.
Who funds this research
None of the 11 trial papers declares a company stake, but 6 give no disclosure in PubMed, including the 1-year trial favoring diet drinks. A urine study had American Beverage Association and International Sweeteners Association ties. Stakes did not change confidence.
- No disclosure in PubMed 6
- No stake declared 5
- Tey 2017No disclosure in PubMed
- Kwok 2024No disclosure in PubMed
- Ahmad 2020No disclosure in PubMed
- Higgins 2019No disclosure in PubMed
- Peters 2016No disclosure in PubMed
- Orku 2023No disclosure in PubMed
- Dalenberg 2020No stake declared
- Ismail 2025No stake declared
- Odegaard 2026No stake declared
- Nichol 2019No stake declared
- Acero 2020No stake declared
Funding rule. A stake is always shown. Confidence is lowered only when every supporting study comes from a party with a stake. "No disclosure in PubMed" means the PubMed record has no conflict-of-interest statement. It does not mean there is no conflict.
All 32 on-topic papers
Each paper shows what it tested, what it found, and who has a stake. Every paper also has its own page that explains how much it counts and how it fits. See every study as a list.
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The Impact of Artificially Sweetened Drinks on Metformin Efficacy.
46 people · 46 children and young people aged 10 to 21 with obesity and prediabetes, all taking metformin
TestedDiet drinks compared with unsweetened drinks for 12 weeks
Mean BMI changed by -0.55 ± 1.49 with unsweetened drinks and -0.23 ± 1.60 with diet drinks. The difference was not statistically clear (p = 0.6). Pilot study, too small to be sure.
No differenceNo stake declaredAbstract onlyNo competing interests declared.
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Changes in Non-Nutritive Sweetener Consumption Patterns in Response to a Sugar-Sweetened Beverage Reduction Intervention.
101 people · 101 adults in a 6-month program to cut sugary drinks
TestedCompared people who cut sugary drinks and raised sweetener intake with those who cut sugary drinks only, or did not cut
Sweetener intake rose (aspartame +37.2 ± 13.9 mg a day; total +63.7 ± 18.5 mg a day). No significant weight or BMI changes between the three groups over time.
No differenceNo stake declaredAbstract onlyNo conflict of interest declared.
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Randomized trial · measured the question itselfHiggins et al., 2019The American journal of clinical nutrition · PubMed
A randomized controlled trial contrasting the effects of 4 low-calorie sweeteners and sucrose on body weight in adults with overweight or obesity.
123 people · 154 adults aged 18 to 60 with overweight or obesity (123 finished)
Tested1.25 to 1.75 L a day of drink sweetened with sugar, aspartame, saccharin, sucralose or rebaudioside A, for 12 weeks
Sugar and saccharin groups gained weight (+1.85 ± 0.36 kg and +1.18 ± 0.36 kg; P ≤ 0.02). No clear weight change with aspartame, sucralose or rebaudioside A. Blood sugar tolerance did not change.
MixedNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Randomized trial · measured the question itselfPeters et al., 2016Obesity (Silver Spring, Md.) · PubMed
The effects of water and non-nutritive sweetened beverages on weight loss and weight maintenance: A randomized clinical trial.
303 people · 303 weight-stable adults with overweight or obesity, in a weight loss program
Tested24 ounces (710 ml) a day of diet drinks or water for 1 year
At 1 year the water group kept off 2.45 ± 5.59 kg and the diet drink group 6.21 ± 7.65 kg (P < 0.001 for difference).
Points to benefitNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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The Effect of Substituting Water for Artificially Sweetened Beverages on Glycemic and Weight Measures in People With Type 2 Diabetes: The Study of Drinks With Artificial Sweeteners (SODAS), a Randomized Trial.
179 people · 181 adults with type 2 diabetes who already drank diet drinks regularly
Tested24 oz a day of their usual diet drink or plain water in its place, for 24 weeks
HbA1c was 0.29% (SE 0.12; P = 0.013) higher in the water group than the diet drink group. Body weight and other secondary measures showed no significant effects.
Points to benefitNo stake declaredAbstract onlyNo potential conflicts of interest reported.
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Comparison of a Daily Steviol Glycoside Beverage compared with a Sucrose Beverage for Four Weeks on Gut Microbiome in Healthy Adults.
59 people · 59 healthy adults, average age 31, normal weight
TestedA daily drink with stevia (25% of the daily safe limit) compared with 30 g sugar, for 4 weeks, then 4 weeks off
Main outcome, gut bacteria, did not differ. At week 4, BMI had increased by 0.3 kg/m2 (P = 0.013) in sucrose compared with stevia. Other body and blood measures did not differ.
No differenceNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Randomized trial · lab tests or safetyOrku et al., 2023Nutrition (Burbank, Los Angeles County, Calif.) · PubMed
The effect of regular consumption of four low- or no-calorie sweeteners on glycemic response in healthy women: A randomized controlled trial.
42 people · 42 healthy young women with normal blood sugar who did not usually use sweeteners
Tested330 mL a day of water sweetened with saccharin, sucralose, or aspartame plus ace-K, compared with plain water, for 4 weeks
No differences in blood sugar, insulin, GLP-1, HbA1c or insulin resistance score versus plain water. No effect on body weight, body composition or waist size.
No differenceNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Short-Term Consumption of Sucralose with, but Not without, Carbohydrate Impairs Neural and Metabolic Sensitivity to Sugar in Humans.
healthy adults
TestedSeven sucralose-sweetened drinks over 10 days, with or without a carbohydrate added; carbohydrate alone was also tested
Sucralose drinks taken with a carbohydrate, but not without, lowered insulin sensitivity over 10 days. Brain responses to sweet taste also dropped. Carbohydrate alone had no effect.
Points to harmNo stake declaredAbstract onlyNo competing interests declared.
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Randomized trial · lab tests or safetyAhmad et al., 2020Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme · PubMed
The effect of the artificial sweeteners on glucose metabolism in healthy adults: a randomized, double-blinded, crossover clinical trial.
17 people · 17 healthy adults, average age 24, normal weight
TestedAspartame (0.425 g) or sucralose (0.136 g) each day for 2 weeks, compared with baseline
Blood sugar, insulin, GLP-1 and leptin responses were similar to baseline for both sweeteners. Insulin sensitivity did not change.
No differenceNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Effects of Sucralose Ingestion versus Sucralose Taste on Metabolic Responses to an Oral Glucose Tolerance Test in Participants with Normal Weight and Obesity: A Randomized Crossover Trial.
21 people · 21 adults without diabetes: 10 with normal weight and 11 with obesity
TestedSucralose swallowed, sucralose tasted and spat out, or water, before a sugar tolerance test
Compared with water, swallowed sucralose raised blood sugar area under the curve by 30 ± 10% in both groups. Insulin response differed by weight group. Insulin sensitivity rose 52 ± 20% in normal-weight people but not in people with obesity.
MixedNo stake declaredAbstract onlyNo conflict of interest declared.
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Randomized trial · lab tests or safetyTey et al., 2017International journal of obesity (2005) · PubMed
Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake.
30 people · 30 healthy men
TestedOne mid-morning drink sweetened with aspartame, monk fruit, stevia or 65 g sucrose, each on a different day
Lunch intake was higher after sweetener drinks than sucrose (P=0.010), but total daily energy intake did not differ (P=0.831). Total 3-hour blood sugar (P=0.960) and insulin (P=0.216) did not differ.
No differenceNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Population study: followed a groupEspinosa et al., 2026The American journal of clinical nutrition · PubMed
Artificially sweetened beverages and weight change: findings from 3 prospective cohort studies of United States adults.
143,409 people · 143,409 US adults aged 26 to 65, followed a median 28 years
TestedChanges in diet drink intake, and swapping sugary drinks for diet drinks or water, compared with 4-year weight change
Each 3-serving a week rise in diet drinks went with -0.18 kg weight change (95% CI: -0.26 kg, -0.11 kg) per 4 years. Swapping 3 sugary servings a week for diet drinks went with -1.39 kg (95% CI: -1.50 kg, -1.28 kg).
Points to benefitNo stake declaredAbstract onlyNo conflicts of interest declared; funded by NIH.
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The association of sweetened beverage intake with risk of type 2 diabetes in an Australian population: A longitudinal study.
36,608 people · 36,608 Australians aged 40 to 69
TestedDrinking diet or sugary drinks at least once a day, compared with never or less than once a month
High diet drink intake was linked to higher type 2 diabetes risk (IRR = 1.38; 95 % CI: 1.18-1.61). Sugary drinks IRR = 1.23. Adjusting for BMI removed the link for sugary drinks but not diet drinks.
Points to harmNo stake declaredAbstract onlyNo competing interests declared.
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Association between coffee consumption and metabolic syndrome: A cross-sectional and Mendelian randomization study.
351,805 people · 351805 UK adults, coffee drinkers and non-drinkers
TestedCoffee intake and its link to metabolic syndrome, split by use of milk, sugar or artificial sweetener
Sweetener used with coffee was positively linked to metabolic syndrome and all its parts. Main finding: 1 cup of coffee a day went with lower odds of metabolic syndrome (OR: 0.88).
Points to harmNo stake declaredAbstract onlyNo conflict of interest declared.
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Prevalence of low-calorie sweetener intake in South Asian adults.
892 people · 892 South Asian adults living in the US, average age 55
TestedPeople who used low-calorie sweeteners compared with people who did not, at one point in time
Twenty-two percent reported sweetener use. Use was linked to more body fat and to higher odds of high blood pressure, high cholesterol and diabetes. A one-time snapshot cannot show cause.
Points to harmNo stake declaredAbstract onlyNo potential conflicts of interest declared.
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Chronic Low-Calorie Sweetener Use and Risk of Abdominal Obesity among Older Adults: A Cohort Study.
1,454 people · 1454 adults in a US aging study, followed a median of 10 years
TestedPeople who used low-calorie sweeteners compared with non-users
Users had 0.80 kg/m2 higher BMI (95% CI, 0.17-1.44), 2.6 cm larger waist, and 53% higher incidence of abdominal obesity (hazard ratio = 1.53; 95% CI 1.10-2.12).
Points to harmNo stake declaredAbstract onlyNo competing interests declared.
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Urinary Sweeteners and Sugars in Relation to Childhood Obesity: The SWEET Project.
500 people · 500 Dutch children and teens aged 8 to 17
TestedSweetener and sugar levels in overnight urine, compared with BMI and waist-to-height scores
Urinary saccharin was linked to higher BMI z-score [βmg/mL: 51.59 (95% CI: 7.96, 95.21)] and sucralose to BMI z-score [291.29 (98.01, 484.58)]. Total sweeteners, acesulfame, cyclamate and steviol showed no link.
Points to harmCompany stakeAbstract onlySome authors get research funding from the American Beverage Association, or honoraria from the International Sweeteners Association and others.
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Effects of Nonnutritive Sweeteners on the BMI of Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies.
12 studies · children and teens in 4 trials (1372 people) and 8 cohort studies (35,340 people)
TestedDiet drinks compared with sugar-sweetened drinks in trials; diet drink intake over time in cohorts
In trials, diet drinks led to less BMI gain than sugary drinks (mean difference = -0.114 kg/m2; 95% CI -0.207, -0.021). In cohorts, the link to BMI gain was not clear (0.05 kg/m2; 95% CI -0.03, 0.13).
MixedNo disclosure in PubMedAbstract onlyNo disclosure in PubMed. Some included trials had company ties; removing them weakened results.
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Effect of perinatal consumption of low-calorie sweetener on maternal health: A systematic review and meta-analysis.
19 studies, 203,706 people · pregnant women in 19 studies
TestedSweetener use in pregnancy compared with no use
Sweetener use was linked to 11% higher risk of preterm birth (RR = 1.11, 95% CI: 1.07-1.16). No link to weight gain in pregnancy (SMD = 0.04; 95% CI: -0.17 - 0.24).
MixedNo stake declaredAbstract onlyNo competing interests declared.
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Artificially Sweetened Beverages and Health Outcomes: An Umbrella Review.
55 studies · people in 51 cohort and 4 case-control studies, drawn from 11 earlier pooled analyses
TestedPeople who drink diet drinks often, compared with people who drink few or none
Diet drinks were linked to higher risk of obesity, type 2 diabetes, high blood pressure and heart disease, with highly suggestive evidence. Authors say more cohort studies and trials are needed.
Points to harmNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Consumption of Non-Nutritive Sweetener during Pregnancy and Weight Gain in Offspring: Evidence from Human Studies.
6 studies · mothers who used sweeteners in pregnancy and their babies up to age 1
TestedSweetener use in pregnancy compared with none or lower use
Babies of mothers who used sweeteners had higher BMI z score at age 1 (weighted mean difference 0.19; 95% CI 0.07, 0.31; p=0.002). Evidence was rated low quality.
Points to harmNo stake declaredAbstract onlyNo competing interests declared.
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Nonalcoholic fatty liver disease, insulin resistance, and sweeteners: a literature review.
people who use sweeteners for weight loss or blood sugar control
TestedReview of artificial and natural sweeteners, fatty liver and insulin resistance
Authors conclude artificial sweeteners, because of their effect on fatty liver and insulin resistance, are not indicated in patients with obesity or diabetes. Natural sweeteners such as stevia may be protective.
Points to harmNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies.
56 studies · healthy adults and children, with or without overweight, in 56 studies (35 observational)
TestedSweetener use compared with no use, lower use or sugar
In adults, sweeteners were linked to lower BMI (mean difference -0.6, 95% CI -1.19 to -0.01; two studies, n=174). In children, BMI z score rose less than with sugar (-0.15, -0.17 to -0.12). Most other outcomes showed no difference.
MixedNo stake declaredAbstract onlySupported by WHO. No financial ties to groups with an interest in the work.
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Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials.
29 studies, 741 people · people in 29 trials, mixed ages, weights and diabetes status
TestedAspartame, saccharin, stevioside or sucralose, compared with baseline blood sugar
Sweetener use did not raise blood sugar, and levels gradually declined after use. Effect did not differ by sweetener type.
No differenceNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Pooled review (meta-analysis)Azad et al., 2017CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · PubMed
Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies.
37 studies · adults and teens in 7 trials (1003 people) and 30 long-term cohort studies (405 907 people)
TestedSweetener use compared with no or less sweetener use; trials median 6 months, cohorts median 10 years
In trials, sweeteners had no clear effect on BMI (mean difference -0.37 kg/m2; 95% CI -1.10 to 0.36). In cohort studies, sweetener use was linked to higher BMI (mean correlation 0.05, 95% CI 0.03 to 0.06).
MixedNo stake declaredAbstract onlyOne author had speaker fees from Medtronic, which does not make sweeteners. Otherwise no competing interests.
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Pooled review (meta-analysis)Ruanpeng et al., 2017QJM : monthly journal of the Association of Physicians · PubMed
Sugar and artificially sweetened beverages linked to obesity: a systematic review and meta-analysis.
3 studies · people in 3 studies of diet soda and obesity (11 more studies on sugary soda)
TestedDrinking diet soda compared with not drinking soda
Pooled risk of obesity was 1.59 (95% CI, 1.22-2.08) for diet soda drinkers. For sugary soda it was 1.18 (95% CI, 1.10-1.27).
Points to harmNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Health outcomes of non-nutritive sweeteners: analysis of the research landscape.
372 studies · people in 372 human studies of sweeteners, including 155 trials
TestedMap of studies on regular sweetener use and any health outcome
For weight gain, obesity risk, diabetes, cancer and appetite, there is no conclusive evidence for benefit or harm. Many other outcomes had few studies.
No differenceNo stake declaredAbstract onlyNo competing interests declared.
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Aspartame and Obesity: A Comprehensive Review of Mechanisms of Action, Transgenerational Effects, and Health Implications.
people and animals exposed to aspartame, including pregnant mothers and their offspring
TestedReview of how aspartame might affect body weight
Describes possible ways aspartame may affect weight, such as appetite and gut bacteria, and possible effects in children of mothers who used it. Says the long-term link to obesity is still debated.
No weight on the ladderNo stake declaredAbstract onlyNo conflicts of interest declared.
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Is the Use of Artificial Sweeteners Beneficial for Patients with Diabetes Mellitus? The Advantages and Disadvantages of Artificial Sweeteners.
people with or at risk of diabetes and obesity
TestedReview of what sweeteners do to blood sugar, gut bacteria and body weight
Says human meta-analyses found no effect on body weight or blood sugar control. Newer studies suggest effects on glucose absorption, insulin and gut bacteria. Author says their role in diabetes and obesity treatment should be reconsidered.
No weight on the ladderNo stake declaredAbstract onlyNo conflict of interest declared.
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Low-calorie sweetener use, weight, and metabolic health among children: A mini-review.
children and teens
TestedReview of studies on low-calorie sweeteners, appetite, food intake and body weight in children
Observational studies link sweetener use to weight gain. Most intervention studies report benefits for reducing excess child weight gain. Studies of appetite and food intake are mixed. Authors say evidence is limited.
No weight on the ladderNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Artificial sweeteners and metabolic dysregulation: Lessons learned from agriculture and the laboratory.
animals on farms and in labs, plus long-term human studies
TestedReview of artificial sweeteners and weight and metabolism
Long-term human studies raise concern that sweeteners may add to obesity, type 2 diabetes and heart disease. Animal studies suggest sweeteners may promote food intake and weight gain.
No weight on the ladderNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Low-calorie sweetener use and energy balance: Results from experimental studies in animals, and large-scale prospective studies in humans.
animals in lab and farm studies, and adults in large long-term human studies
TestedReview of low-calorie sweeteners, weight gain and metabolic health
Animals given sweeteners showed more food intake, weight gain and body fat than animals given water. Large human cohorts link daily diet drink use to weight gain, belly fat and obesity. Author calls the results troubling.
No weight on the ladderNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
22 papers we read and set aside as off topic
- Pagliai et al., 2020. Nutritional Interventions in the Management of Fibromyalgia Syndrome. (systematic review)
- Boon et al., 2025. A Systematic Review of Nonsugar Sweeteners and Cancer Epidemiology Studies. (systematic review)
- Ahmad et al., 2020. The Effects of Non-Nutritive Artificial Sweeteners, Aspartame and Sucralose, on the Gut Microbiome in Healthy Adults: Secondary Outcomes of a Randomized Double-Blinded Crossover Clinical Trial. (randomized trial)
- Chakravartti et al., 2025. Non-caloric sweetener effects on brain appetite regulation in individuals across varying body weights. (randomized trial)
- Halasa et al., 2023. Non-Nutritive Sweeteners in Human Amniotic Fluid and Cord Blood: Evidence of Transplacental Fetal Exposure. (other)
- Cogan et al., 2024. Differential effects of nutritive and non-nutritive sweet mouth rinsing on appetite in adults with obesity. (randomized trial)
- López-Meza et al., 2022. The impact of nutritive and non-nutritive sweeteners on the central nervous system: preliminary study. (randomized trial)
- Wang et al., 2014. BMI modulates calorie-dependent dopamine changes in accumbens from glucose intake. (trial, not randomized)
- Ye et al., 2024. Hyperglycemia and Central Obesity Disrupt Conditioned Pain Modulation: A Single-Blind Crossover Randomized Controlled Trial. (randomized trial)
- Klein et al., 2010. Modified sham feeding of sweet solutions in women with anorexia nervosa. (randomized trial)
- Drewnowski et al., 2001. Genetic taste responses to 6-n-propylthiouracil among adults: a screening tool for epidemiological studies. (population study: one-time survey)
- Tamam et al., 2012. Overweight and obese boys reduce food intake in response to a glucose drink but fail to increase intake in response to exercise of short duration. (randomized trial)
- van Opstal et al., 2019. Dietary sugars and non-caloric sweeteners elicit different homeostatic and hedonic responses in the brain. (randomized trial)
- Debras et al., 2022. Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study. (population study: followed a group)
- Sun et al., 2024. Artificial sweeteners and risk of incident cardiovascular disease and mortality: evidence from UK Biobank. (population study: followed a group)
- Mao et al., 2024. Artificial Sweetener and the Risk of Adverse Pregnancy Outcomes: A Mendelian Randomization Study. (gene study (mendelian randomization))
- Martyn et al., 2016. Dietary intake of four artificial sweeteners by Irish pre-school children. (population study: one-time survey)
- Sylvetsky et al., 2017. Consumption of Low-Calorie Sweeteners among Children and Adults in the United States. (population study: one-time survey)
- Ulambayar et al., 2025. Artificial Sweetener Use in Hungary: A Cross-Sectional Study on Socioeconomic and Health Disparities from a Public Health Perspective. (population study: one-time survey)
- Daher et al., 2022. Trends and amounts of consumption of low-calorie sweeteners: A cross-sectional study. (population study: one-time survey)
- Yildirim-Kahriman et al., 2025. Understanding real and mythical cancer risk factors: Insights from a university-based study. (population study: one-time survey)
- Bayram et al., 2022. Added sugars and non-nutritive sweeteners in the food supply: Are they a threat for consumers? (population study: one-time survey)
Words on this page
- SMD (standardized mean difference)
- A way to compare results measured on different scales. About 0.2 is a small effect, 0.5 medium, and 0.8 large.
- Hazard ratio (HR)
- Compares how often something happened in two groups over time. 1 means no difference. 0.80 means 20% lower risk; 1.20 means 20% higher.
- Relative risk (RR)
- Compares the risk in two groups. 1 means no difference. 0.85 means 15% lower risk.
- Odds ratio (OR)
- Another way to compare two groups. 1 means no difference. Below 1 means lower odds, above 1 higher odds.
- 95% CI (confidence interval)
- The range where the true result likely lies. If the range includes no effect (1 for ratios, 0 for differences), the result is not clear.
- p-value (p =)
- How likely a result this large would be by chance if there were no real effect. Below 0.05 is usually called a clear result.
- Pooled review (meta-analysis)
- A study that combines the results of many earlier studies to get one overall answer.
- Umbrella review
- A review of many pooled reviews.
- Cohort study
- A study that follows a large group of people over years. It shows links, not causes.
How the short answer is set
Fixed rules turn the studies into the short answer, so the same studies always give the same answer. The rules start from GRADE, a standard system for rating evidence, in plain language.
| Confidence | What it means |
|---|---|
| High | We are confident the answer is right. |
| Moderate | The answer is probably right, but it could change. |
| Low (this page) | The answer may well change. |
| Very low | Any answer is very uncertain. |
| Not tested in people | Only cell or animal studies exist. |
Why low here
- Trials measured body weight, but most were small and lasted 4 to 24 weeks.
- Trials and population studies point in different directions.
- Pooled adult trial result rests on 242 people; its range includes no effect.
- Trials compared sweeteners with different things: water, sugar, or each other.
Hard limit used. The longest single trial here lasted 1 year, so effects over many years rest on population studies, which show links, not causes.
How this page was made
Label
- Search
- PubMed, Nov 14, 2026. Searches written by Claude Opus 5.5; papers ranked by PubMed
- First read of all 54 papers
- Claude Sonnet
- Independent second read
- Claude Haiku
- Disagreements settled by
- Claude Opus 5.5
- Page text written by
- Claude Opus 5.5
- Charts
- Drawn by code from the study records
- Source check by a person
- Not yet. Required before search engines may list this page.
- Expert review
- No
- Papers read in full
- 0 of 54; all from PubMed abstracts
- Method
- v0.2, created Nov 14, 2026
Search. We ran four PubMed searches for artificial (non-sugar) sweeteners and body weight and metabolic health: pooled and systematic reviews since 2012 (10 of 32), trials in people (22 of 107), population studies (22 of 93). The first number is how many papers we read; the second is how many PubMed found. We took the ones PubMed ranks as most relevant. See the full PubMed search. Of the 54 papers read, 32 were on topic.
Limits. Digestery reads at most about 60 papers per question, so large fields are sampled, not covered in full. Abstracts can leave out key details, such as side effects and funding.
Review queue
These items wait for a person. Search engines are asked not to list the page until the first one is done.
- OpenThe short answer is new. It waits for a source check by a person.
- OpenAhmad 2020 and Ahmad 2020 share research group, doses and 17 people; likely one crossover trial. Only Ahmad 2020 discloses a PepsiCo honorarium.
- OpenSix trial papers have no COI statement in PubMed: Peters 2016, Higgins 2019, Tey 2017, Kwok 2024, Ahmad 2020, Orku 2023. Check full texts for funding.
- OpenChakravartti 2025 (sucralose raised hunger more than sugar, brain scans) kept off-topic: no weight or blood sugar main outcome. Confirm exclusion.
- OpenOdegaard 2026 direction set to help: HbA1c better with diet drinks than water; weight did not differ. Confirm this framing.
- OpenHiggins 2019 n set to 123 completers; abstract does not say how many of 154 randomized were analyzed.
- OpenEspinosa 2024: removing studies with conflicts of interest weakened estimates; abstract does not name which pooled trials had company ties.
- OpenStevia trial Kwok 2024 counted as a non-sugar sweetener; confirm stevia fits this topic's artificial sweetener scope.
Page history
| Date | Change | Reason |
|---|---|---|
| Nov 14, 2026 | Page created from 54 papers. | First version of the page. |
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