Low- or No-Energy Sweeteners and Body Weight Management: Dissecting a "Minor" Effect.

Nonnutritive sweeteners were introduced on the market over a century ago to displace the calories of added sugars in foods and beverages and, therefore, facilitate weight loss. In spite of their widespread use, obesity has reached epidemic proportions. The present paper addresses this apparent paradox. Low- or no-energy sweeteners (LNES) are a small group of widely different substances that can be used to modify one single aspect of energy intake, i.e., consumption of added sugars. Their potential benefits for weight management can be predicted by energy balance equations. Decades of research confirm that LNES affect weight via a purely nutritional mechanism, in proportion of their actual displacement of sugar energy. LNES allow a substantial decrease in energy density of beverages (as opposed to solid foods) and can be maximally effective in consumers of sugar-containing drinks. Their average effect is robust but modest (1-2-kg weight loss) compared to comprehensive weight-loss programs (±5 kg), medication, or surgery (+10% of initial weight). Other benefits of LNES include sensory-specific satiety for sweet foods, improved diet adherence, and facilitation of weight-loss maintenance. Whether these effects are considered minor or major benefits in the present obesogenic context is a matter of individual definition.