Dr Novella Gives Skeptical Opinion of Low Cal Drinks

According to Dr Steven Novella in his blog post, New Review of Artificial Sweeteners, July 19, 2017,

If you are trying to lose weight replacing sugary drinks with low calorie drinks can be a helpful part of your overall strategy. It will not be a panacea, or make weight loss easy. The research shows the most effective strategies involve making permanent changes to your lifestyle regarding food consumption and exercise. Avoiding sugary drinks can be part of those lifestyle changes, and you should not fear drinking LES because of an alleged backfire effect. The research, including this recent review, does not show such an effect in humans.

He clarifies this conclusion as follows:

I think the bottom line is that weight loss is difficult and complex. . . There are many variables, and no study will ever be able to control for all of them. The net effect of consuming LES vs sugary drinks or water is likely dependent on the individual and the situation. But I do think we can draw a couple of conclusions from all the available research. 

The first question is this – is there a health or weight disadvantage to consuming sugar? I think the answer here is a clear yes. Sugary drinks contain many calories that add to total calorie consumption and are counterproductive if your goal is calorie control for weight management. Replacing high calorie sugary drinks with low calorie drinks is therefore advantageous.

The second question is this – is there an unintended backfire effect to consuming LES, because it tricks the brain into being more hungry or some other hormonal or metabolic effect? Here I think the answer is probably no,. . . Randomized controlled trials in humans supersede cohort studies and animal studies in addressing this question. Those studies find, if anything, a modest benefit to consuming LES.. . The randomized trials clearly do not show any disadvantage – no backfire effect.

https://sciencebasedmedicine.org/new-review-of-artificial-sweeteners/