SUN-657 Are Artificial Sweeteners a Useful Tool For Intentional Weight-loss?: Systematic Review and Meta-analysis

Abstract Disclosure: A. Chariton: Author of Shortcut U, Substack Blog. J.C. Cardoso: None. J.F. Lapenda: None. C. Pedagarla: None. T.F. Araújo: None. V. Acioli da Cunha: None. E. Shams: None. V. Challa: None. M.C. Souza: None. M. Correia: None. Introduction: Artificial sweeteners (AS) provide sweet taste without adding calories as part of reduced-calorie diets for the management of obesity. However, the literature on artificial sweetener consumption and body weight is unclear due to conflicting outcomes between observational studies and randomized-controlled trials (RCTs) and the heterogeneity of RCT study designs. Methods: Pubmed, SCOPUS, and Cochrane databases were systematically searched, from inception to November, 2024, for RCTs comparing the efficacy of weight-loss protocols that included AS consumption with controls which did not. Statistical analysis was performed in R software 4.4.1., a DerSimonian and Laird fixed-effects model was employed to compute mean differences (MD) and standard mean differences (SMD) with 95% confidence intervals (CI) and a p-value of <0.05 was considered statistically significant. Heterogeneity was examined with the Cochran Q test, prediction interval and I2 statistics. The results were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guideline. The protocol was prospectively registered in PROSPERO under CRD42025634280. Results: There were 7 studies (n=1,479) that met the inclusion criteria for active weight-loss outcomes, and 4 studies (n=656) for a separate analysis of weight-loss maintenance outcomes. After a mean active weight-loss period of 18 weeks, there were no statistically significant differences for the primary outcome of body weight (MD:−0.0665Kg, 95% CI:[−0.4511;0.3182], P=0.945, I2=78.4%) nor for the secondary outcomes of waist circumference and systolic blood pressure. There were small but statistically significant differences favoring control for the secondary outcomes of diastolic blood pressure (MD:1.7672mmHg, 95% CI:[0.1106;3.4237], P=0.037, I2=0.0%) and body mass index (MD:0.5403Kg/cm2, 95% CI:[0.1947;0.8860], P=0.002, I2=0.0%). Data for weight-loss maintenance was similar for body weight (SMD:−0.3156, 95% CI:[−0.4710;−0.1602], P=0.370, I2=86.1%), waist circumference, and systolic blood pressure. Qualitatively, all AS groups achieved statistically significant decreases in body weight during active weight-loss, and subjects in 3 of the maintenance studies maintained all weight-loss, with those in the fourth study maintaining the majority. Conclusion: Both AS and control groups were associated with weight-loss and weight-loss maintenance in RCTs with no clinically significant differences. AS consumption may be useful for aiding in weight-loss and maintenance depending on individual dietary preferences and craving responses during weight-loss protocols. Presentation: Sunday, July 13, 2025