Artificial Sweetener Increases Appetite in Women and People With Obesity

[David Baxter PhD]

Artificial Sweetener Ups Appetite in Women, People With Obesity​

by Marlene Busko, Medscape
October 5, 2021

A new study suggests that replacing sugar (sucrose) with the nonnutritive sweetener sucralose may not have the desired weight-loss effect, and in fact, it appears to increase appetite in women and people with obesity.

These are novel insights and further studies are needed, experts say.

After consuming a drink sweetened with sucralose versus sucrose, 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 Keck School of Medicine, University of Southern California, Los Angeles, summarized in a press release from the university.

"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 added.

Although many people use artificial sweeteners to try to lose weight, Page noted their place in a healthy diet is controversial. Some studies suggest they may be helpful, while others show they may contribute 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 nonnutritive sweeteners.

The study, by Alexandra G. Yunker, an MPH candidate in nutrition at Harvard University, Boston, Massachusetts, and colleagues, was published online September 28 in JAMA Network Open.

Novel Findings, Need to Consider Sex, Adiposity in Future Research ​

The current study "is of great importance as it provides novel insights into how adiposity and sex are associated with neural and behavioral outcomes of [nonnutritive sweetener] ingestion," Stephanie Kullmann, PhD, writes in an accompanying invited commentary.

"They show for the first time that female individuals with obesity are particularly vulnerable to greater neural responsivity elicited by acute sucralose consumption, particularly in prefrontal reward-associated brain regions," said Kullmann, 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, before being able to discourage use of nonnutritive sweeteners as part of a healthful diet, she cautioned, "we need further studies of their effects on a variety of neurobehavioral and metabolic outcomes."

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