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Diet drinks may be getting a reputation upgrade. A major two-year randomized trial of 493 adults found that diet beverages performed just as well as water for weight loss and weight maintenance — with no evidence of increased appetite or metabolic harm. The findings add important long-term clinical evidence to ongoing debates around WHO guidance on non-sugar sweeteners.
Researchers at the University of Liverpool completed what they describe as the longest and most rigorous randomized controlled trial on diet drinks to date — and the results are reassuring. Over 104 weeks, adults with overweight or obesity who drank diet beverages (sweetened with aspartame, acesulfame-K, or sucralose) lost a similar amount of weight as those who drank plain water, with no meaningful differences in appetite regulation or metabolic health.
The SWITCH trial enrolled 493 participants in a structured behavioral weight management program. Both groups saw improvements in waist and hip circumference, body composition, and metabolic biomarkers — and maintained those results even after structured support ended in year two.
Why it matters: These findings push back on WHO guidance advising against non-sugar sweeteners for weight control, which was based largely on observational data. For clinicians counseling patients on weight management, this trial offers long-term evidence that diet drinks are a viable and safe alternative to sugary beverages.