Yes, replacing regular soda with diet soda will lead to weight loss

If you are new to my diet soda obsession, start here.  (Short version; I think it is human nature to way oversell the idea that diet soda just must be bad for you).

Of course, the main purpose of diet soda is to reduce calorie consumption while still maintaining the sensory enjoyment of soda (and, yes, I love drinking Diet Dr Pepper).  Many correlational studies have found that diet soda does not actually help people lose weight, but there’s a ton of confounds in all this.  Anyway, here’s a nice study (thanks, BB) that summarizes RCT’s and shows that yes, if you use diet soda as intended– as a replacement for sugar sweetened soda– it will lead to weight loss (or less weight gain, as the case may be):

There is an ongoing debate about the possible influences of nonnutritive sweeteners (NNS) on body weight. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) with NNS to assess their impact on body weight. We systematically searched for RCTs at least 4 weeks in duration, evaluating the effect of NNS on body weight, both in subjects with healthy weight and in subjects with overweight/obesity at any age, and compared the effects of NNS vs caloric and noncaloric comparators. The primary outcome was the difference in body weight between NNS and comparators. Twenty studies were eligible (n = 2914). Participants consuming NNS showed significant weight/BMI differences favouring NNS compared with nonusers. Grouping by nature of comparator revealed that NNS vs placebo/no intervention and NNS vs water produced no effect. When comparing NNS vs sucrose, significant weight/BMI differences appeared favouring NNS. Consumption of NNS led to significantly negative weight/BMI differences in unrestricted energy diets, but not in weight-reduction diets. Participants with overweight/obesity and adults showed significant favourable weight/BMI differences with NNS. Data suggest that replacing sugar with NNS leads to weight reduction, particularly in participants with overweight/obesity under an unrestricted diet, information that could be utilized for evidence-based public policy decisions.

To be fair, there’s genuine concerns about how artificial sweeteners may impact the gut microbiome,(if anything, maybe a good case to stick with Aspartame— the best one, anyway– over sucralose) but, to this point, there’s just not a lot of evidence that diet sodas are “bad for you” as so many want to believe.  If you drink regular soda and want to lose weight, there’s a good argument to be made for replacing it with diet soda.

Quasi-unrelated, but I came across this yesterday.  There’s a ton of interesting things to say about the new weight loss drugs (Derek Thompson is a fan), but, the reality is that they seem to be hugely effective for helping people lose weight with very tolerable and no dangerous side effects.  The NYT has an article with this scary headline, “Those Weight Loss Drugs May Do a Number on Your Face” and it’s like, whoa, what are these drugs doing to your face??  They are making you lose a lot of weight, which can actually make you look older.  That whole frame plus many of the comments give off a vibe of “it’s cheating to lose weight with drugs and not have to face major negative consequences” that really reminds me of the “of course diet soda is bad for you” vibe I get all the time.  The next person who brings up the microbiome with me, will get a thoughtful discussion, alas, most all I ever hear is “the chemicals!!” (watch out for dihydrogen monoxide). 

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