The effects of water and non‐nutritive sweetened beverages on weight loss and weight maintenance: A randomized clinical trial

OBJECTIVE: To evaluate the effects of water versus beverages sweetened with non‐nutritive sweeteners (NNS) on body weight in subjects enrolled in a year‐long behavioral weight loss treatment program. METHODS: The study used a randomized equivalence design with NNS or water beverages as the main factor in a trial among 303 weight‐stable people with overweight and obesity. All participants participated in a weight loss program plus assignment to consume 24 ounces (710 ml) of water or NNS beverages daily for 1 year. RESULTS: NNS and water treatments were non‐equivalent, with NNS treatment showing greater weight loss at the end of 1 year. At 1 year subjects receiving water had maintained a 2.45 ± 5.59 kg weight loss while those receiving NNS beverages maintained a loss of 6.21 ± 7.65 kg (P < 0.001 for difference). CONCLUSIONS: Water and NNS beverages were not equivalent for weight loss and maintenance during a 1‐year behavioral treatment program. NNS beverages were superior for weight loss and weight maintenance in a population consisting of regular users of NNS beverages who either maintained or discontinued consumption of these beverages and consumed water during a structured weight loss program. These results suggest that NNS beverages can be an effective tool for weight loss and maintenance within the context of a weight management program.