Fake Sweets, Real Fat: Why Artificial Sweeteners Miss the Mark

If only healthy living allowed us to have our sugar-stuffed cake and eat it too. For decades, nutritional research, and billions of dollars, have been poured into one central promise: that we could enjoy sweetness without consequence. Artificial sweeteners were marketed as the solution, a way to bypass calories, weight gain, and metabolic harm while still indulging our taste for sugar.

Many of us wanted to believe it. Yet for others, doubt crept in—not only because it seemed too good to be true, but because despite widespread adoption of low-calorie “fake” sweeteners, the obesity epidemic continued to worsen. For those of us practicing functional medicine and committed to critical thinking, the findings of a long-term study published in the International Journal of Obesity come as little surprise.

What makes this research particularly compelling is its scope. The study followed 2,745 participants over a 25-year period beginning in 1985. Researchers analyzed dietary intake of artificial sweeteners—specifically aspartame and saccharin—and compared those data with direct measurements of fat thickness using CT scans. The results were clear: higher intake of these artificial sweeteners correlated with increased fat thickness. They were also associated with higher body mass index, greater body weight, and increased waist circumference.

This is not a short-term observational study or a brief dietary trial. It offers a rare, long-range view into how a single dietary choice can influence body composition over decades. While one could argue that CT imaging technology might have revealed these patterns earlier, the length of this study gives its conclusions significant weight.

Interestingly, sucralose did not demonstrate statistically significant changes in this particular analysis. However, that finding should not be interpreted as a clean bill of health. Other research has raised separate concerns regarding sucralose, which we have addressed elsewhere on this site. The broader takeaway remains: the medical profession and public health leadership have likely been mistaken in their longstanding endorsements of artificial sweeteners as a healthier alternative to sugar.

In our effort to avoid calories, we appear to have worsened the very problem we were trying to solve. As a society, we want the pleasure of sweetness without the cost. Yet biology does not work that way. Attempts to bypass consequences often backfire, and artificial sweeteners may be a prime example of that truth.

The solution does not lie in finding the “least harmful” fake sweetener. It lies in moderation, restraint, and a willingness to live within the design of our bodies. We were given a wide range of flavors to enjoy, but we were also warned against excess and against becoming enslaved to our appetites. When pleasure becomes the driver, health inevitably pays the price.

At Sanctuary Functional Medicine, we believe that stewarding our health well requires wisdom, self-control, and humility. Enjoying life’s good gifts in moderation allows us to pursue not only better metabolic health, but the fuller, more abundant life we were created for.

At Sanctuary Functional Medicine, we help patients restore metabolic health through wisdom, moderation, and personalized care, rather than shortcuts. Take the next step toward a healthier, more abundant life.

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Original Article: Brian T. Steffen, David R. Jacobs, So-Yun Yi, Simon J. Lees, James M. Shikany, James G. Terry, Cora E. Lewis, John J. Carr, Xia Zhou, Lyn M. Steffen. Long-term aspartame and saccharin intakes are related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue: the CARDIA study. International Journal of Obesity, 2023; DOI: 10.1038/s41366-023-01336-y   Thanks to Science Daily: University of Minnesota Medical School. "Study links long-term artificial sweetener intake to increased body fat adipose tissue volume." ScienceDaily. ScienceDaily, 3 August 2023. <www.sciencedaily.com/releases/2023/08/230803213830.htm>.