Oct. 6, 2021 – If you’ve switched from sugar to an artificial sweetener made from sucralose as part of a weight-loss strategy, a new study has concerning news: The artificial sweetener may actually increase appetite in women and people with obesity.

Sucralose products come in many forms, including powder that many people use in place of sugar in coffee and other beverages. Common brands include Splenda, Zerocal, Sukrana, SucraPlus, Candys, Cukren, and Nevella. But sucralose is also found in other products, including diet sodas, and sugar-free versions of products like maple syrup, salad dressings and other sauces.

The study found that after consuming a drink sweetened with sucralose versus sugar, women and people with obesity had increased activity in the reward center of the brain, and women ate more food at a post-fasting buffet.

"We were able to show that females and people with obesity may be more sensitive to artificial sweeteners," senior author Kathleen Page, MD, an associate professor of medicine at the university’s Keck School of Medicine, said in a press release.

"For these groups, drinking artificially sweetened drinks may trick the brain into feeling hungry, which may in turn result in more calories being consumed," she said.

Although many people use artificial sweeteners to try to lose weight, Page noted their place in a healthy diet is controversial. Some studies suggest that they may be helpful, while others show that they may be contributing to weight gain, type 2 diabetes, and other metabolic disorders.

The new findings may partly explain these previous differences, she said.

The results also highlight the need to consider gender and body mass index in future research of these kinds of sweeteners. The study was published online Sept. 28 in JAMA Open.

Novel Findings, Need for Future Research

The current study "is of great importance” because it shows sweeteners’ possible effects based on obesity and sex, Stephanie Kullmann, PhD, writes in an accompanying commentary. Kullmann is a post-doctoral fellow at the Institute for Diabetes Research and Metabolic Diseases of Helmholtz Zentrum München at the University of Tübingen, in Germany.

This suggests "that adding nonnutritive sweeteners to our diet to increase sweetness could impair the brain's responsivity to food, with negative consequences for eating behavior and metabolism, particularly in women."

However, more search is needed before doctors and nutritionists tell people not use these sweeteners.

The current study "clearly points out the importance of considering sex and [obesity] in future research to [be able to] give individual tailored dietary recommendations for body weight management."

Several questions remain, says John L. Sievenpiper, MD, PhD, associate professor in the Department of Nutritional Sciences and Medicine at the University of Toronto.

"Was it the sucralose per se or the absence of calories that explains these findings? And the bigger question is, do these differences by [obesity] and sex translate into weight gain?"

Systematic reviews and meta-analyses of the available clinical trials of low and no calorie sweeteners including sucralose show they can lead to weight loss in both males and females who are overweight or obese, he noted.