The Paradox of Artificial Sweeteners in Managing Obesity

  • Jason R. RobertsEmail author
Nutrition and Obesity (S McClave, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Nutrition and Obesity


The role of artificial sweeteners in the management of obesity is controversial. Observational data have suggested that nonnutritive sweeteners (NNSs) may promote weight gain through poorly understood mechanisms of cravings, reward phenomenon, and addictive behavior via opioid receptors. Interventional studies suggest the opposite that substitution of NNS for sugar-sweetened beverages (SSBs) results in reduced caloric intake and modest degrees of weight loss. Whether the use of NNS provides benefit toward weight reduction in the individual patient may depend on the characteristics of their baseline diet, associated changes, or dietary compensation involved with ingestion of NNS, and the degree of compliance with a more complete weight loss program.


Artificial sweeteners Obesity Sugar substitutes 


Compliance with Ethics Guidelines

Conflict of Interest

Jason R. Roberts declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


  1. 1.
    Hu FB, Malik VS. Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. Physiol Behav. 2010;100:47–54.PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Sources of calories from added sugars among the US Population, 2005–06. Applied research program web site. National Cancer Institute. Updated April 11, 2014. Accessed August 27 2014.
  3. 3.
    Malik VS, Popkin BM, Bray GA, Després JP, Hu FB. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation. 2010;121:1356–64.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Dhingra R, Sullivan L, Jacques PF, et al. Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation. 2007;116:480–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Hu FB, Malik VS. Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. Physiol Behav. 2010;100:47–54.PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Schulze MB, Manson JE, Ludwig DS, et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA. 2004;292:927–34.PubMedCrossRefGoogle Scholar
  7. 7.
    Palmer JR, Boggs DA, Krishnan S, et al. Sugar-sweetened beverages and incidence of type 2 diabetes mellitus in African American women. Arch Intern Med. 2008;168:1487–92.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Stanhope KL, Schwarz JM, Keim NL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest. 2009;119:1322–34.PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Mattes RD, Popkin BM. Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms. Am J Clin Nutr. 2009;89:1–14.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    2012 Food and health survey: consumer attitudes toward food safety, nutrition and health. International Food Information Council Foundation. May 2012.Google Scholar
  11. 11.
    Stellman SD, Garfinkel L. Artificial sweetener use and one-year weight change among women. Prev Med. 1986;15:195–202.PubMedCrossRefGoogle Scholar
  12. 12.
    Anderson GH, Foreyt J, Sigman-Grant M, Allison DB. The use of low-calorie sweeteners by adults: impact on weight management. J Nutr. 2012;142:1163S–9S.PubMedCrossRefGoogle Scholar
  13. 13.
    Maersk M, Belza A, Holst JJ, et al. Satiety scores and satiety hormone response after sucrose-sweetened soft drink compared with isocaloric semi-skimmed milk and with noncaloric soft drink: a controlled trial. EJCN. 2012;65:523–9.Google Scholar
  14. 14.
    Raben A, Moller BK, Flint A, et al. Increased postprandial glycemia, insulinemia, and lipidemia after 10 weeks sucrose-rich diet compared to an artificially sweetened diet: a randomized controlled trial. Food Nutr Res. 2011;55:5961.CrossRefGoogle Scholar
  15. 15.
    Mozzaffarian D, Hao PHT, Rimm EB, et al. Changes in diet and lifestyle and long-term weight gain in women and men. NEJM. 2011;364:2392–404.CrossRefGoogle Scholar
  16. 16.
    Ebbeling CB, Feldman HA, Chomitz VR, Antonelli TA, Gortmaker SL, Osganian SK, et al. A randomized trial of sugar-sweetened beverages and adolescent body weight. N Engl J Med. 2012;367(15):1407–16.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    de Ruyter JC, Olthof MR, Seidell JC, Katan MB. A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med. 2012;367(15):1397–406.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of MedicineUniversity of Louisville School of MedicineLouisvilleUSA
  2. 2.Division of Gastroenterology, Hepatology and NutritionUniversity of Louisville School of MedicineLouisvilleUSA

Personalised recommendations