104-Week RCT Finds Diet Drinks Match Water for Weight Loss Maintenance

The double-blind randomized trial assigned participants to a structured behavioral program plus either commercially available diet drinks or water for 104 weeks. Daily sweetener intake stayed below EFSA limits. Both arms showed sustained reductions in weight, waist circumference, body fat, and metabolic markers through the maintenance phase without researcher contact. Sugar intake dropped in both groups, slightly more among diet-drink users. No between-group differences emerged in blood pressure, lipids, or appetite measures. The industry-funded study declared independent analysis and reporting, yet the American Beverage Association support still invites scrutiny given historical patterns of selective emphasis in sweetener research. Results directly counter WHO's 2023 observational-based caution by supplying the longest RCT data to date, building on the team's 2023 International Journal of Obesity findings that short-term appetite regulation was also unaffected. Future policy updates will likely hinge on whether additional independent replications in diverse populations confirm these metabolic neutrality findings. Regulators may also examine whether the structured program itself drove adherence more than beverage choice.