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In a 104-week randomized trial of 493 adults with overweight or obesity, participants assigned diet beverages lost a similar amount of weight to those assigned water. Both groups maintained weight reductions and showed improvements in several health measures; the trial does not establish that diet drinks are better than water or apply to every person.
A 104-week randomized trial led by University of Liverpool researchers found that adults with overweight or obesity assigned to drink diet beverages lost a similar amount of weight to participants assigned water during a structured weight-management program. The findings, published in the British Journal of Nutrition, add long-term clinical evidence to debate over whether non-nutritive sweeteners can support weight management.
The SWITCH trial enrolled 493 adults with overweight or obesity, who were randomly assigned to drink either water or commercially available beverages sweetened with non-nutritive sweeteners. The drinks included products containing aspartame, acesulfame potassium and sucralose. Participants also took part in a structured behavioral weight-management program.
After 104 weeks, average weight loss was 4.8 kilograms in the diet-beverage group and 3.7 kilograms in the water group. Researchers reported that the difference was not statistically significant. Both groups maintained weight reductions over the full study, including during the final year, when participants no longer received assistance.
Participants in both groups also had reductions in waist and hip circumference and improvements in body composition and several metabolic biomarkers. The researchers reported no clinically meaningful differences between groups in measures including blood pressure and cholesterol. Sugar intake fell in both groups, with a somewhat larger reduction among those assigned diet beverages. Sweetener consumption remained within established European Food Safety Authority safety thresholds, according to the study account.
Evidence for Beverage Choices
The findings may help people and health professionals weigh diet drinks against water as alternatives to sugar-sweetened beverages during weight management. In this trial, the diet-beverage group did not lose significantly more weight than the water group, but the results also did not show that these drinks undermined weight loss compared with water.
The results add randomized, long-term clinical data to a discussion that has included concerns about appetite regulation and possible metabolic effects. The researchers said the trial did not support those concerns under the conditions studied. That conclusion is limited to the measures and participants in this trial; it does not establish that diet drinks produce weight loss on their own, nor that they are preferable to water for everyone.
The work may also inform debate over public-health advice. The World Health Organization has advised against using non-sugar sweeteners for weight control, citing uncertainty in evidence that includes observational research. The SWITCH findings offer a different kind of evidence because participants were randomly assigned to a beverage group and followed for two years. Whether the results alter future recommendations is not yet known.
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How the SWITCH Trial Was Set Up
The study tested two related questions: whether reducing dietary sugar affects weight management, and whether replacing sugar with non-nutritive sweeteners changes appetite regulation. Its authors describe it as the longest randomized controlled trial to date examining these beverages. The trial builds on earlier findings reported in the International Journal of Obesity in 2023.
Professor Jo Harrold, Dean of Psychology at the University of Liverpool, led the research with Professor Jason Halford, a biological psychology and health-behavior researcher at the University of Leeds who was formerly at Liverpool. The American Beverage Association funded the study. The research account says the team worked independently from the funder and retained control over analysis and reporting. The report appeared in the peer-reviewed British Journal of Nutrition.
““These latest findings show that concerns about sweeteners disrupting appetite or causing weight gain are not supported when tested in a rigorous, long-term randomized trial.””
— Professor Jo Harrold, University of Liverpool
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Limits of the Two-Year Findings
The reported results do not show whether the groups would remain similar beyond 104 weeks, or how the findings apply to people without overweight or obesity, people outside a structured program, or those with different drinking habits. The source material does not provide detailed information on participant adherence, dropouts, or the size of the reported changes in individual metabolic biomarkers.
The trial compared assigned diet beverages with water; it did not test whether either choice is better than continuing to drink sugar-sweetened beverages in every setting. Nor does a lack of clinically meaningful differences in selected measures establish the absence of every possible long-term effect. The study’s industry funding is disclosed, and the account says the researchers controlled analysis and reporting. Further research and scrutiny of the full paper can help readers assess the methods and results.
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Recommendations After the Trial
The published results give researchers and public-health bodies evidence to consider alongside existing studies. The study team said it hopes the findings inform future WHO guidance and public-health policy, but the available report does not announce a change to any recommendation. For now, the trial supports a limited conclusion: during this program, diet beverages and water performed similarly on weight outcomes over two years.
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Key Questions
How much weight did participants lose?
At 104 weeks, average weight loss was 4.8 kilograms for participants assigned diet beverages and 3.7 kilograms for those assigned water. Researchers said the difference was not statistically significant.
Were diet drinks better than water?
The trial found similar weight outcomes, not that diet drinks were better. Both groups lost weight and maintained reductions during the study.
Which sweeteners were included?
The tested beverages included products containing aspartame, acesulfame potassium and sucralose. The account says participants’ sweetener intake remained within EFSA safety thresholds.
Does this settle whether sweeteners are safe?
No. The study reported no clinically meaningful differences in selected measures such as blood pressure and cholesterol, but it followed participants for 104 weeks and assessed specific outcomes. It does not resolve every question about longer-term effects.
Will the trial change WHO advice?
The researchers hope the results inform future guidance. The available report does not say that WHO has changed its recommendation against using non-sugar sweeteners for weight control.
Source: rss
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