The healthline story is summarizing a large number of studies, all of which have ambiguous results, or show negative side effects.
So, like tobacco (which doctors used to recommend to help with lung health to kill colds, etc), there are a lot of ambiguous "no / little effect" studies in favor of artificial sweeteners, and a lot of studies showing clear negative effects. However, there aren't any showing significant benefits.
It's easy to produce a no-effect study via lazy experimental setup, and slight positive effects via P-hacking for strange things. For example, this quote from [2] looks like P-hacking:
> However, a recent review of nine observational studies noted that artificial sweeteners were associated with a slightly higher BMI — but not with increased body weight or fat mass (17Trusted Source).
Anyway, here are some other quotes from [2] against artificial sweeteners.
I pasted in their conclusion at the bottom of this comment, which can be summarized as "they won't help much, but they might hurt. If you have the following symptoms, discontinue use":
Though artificial sweeteners provide sweet taste, many researchers believe that the lack of calories prevents complete activation of the food reward pathway.
This may be the reason that artificial sweeteners are linked to increased appetite and cravings for sugary food in some studies (8Trusted Source).
Magnetic resonance imaging (MRI) scans in five men showed that sugar consumption decreased signaling in the hypothalamus, the appetite regulator of your brain (9Trusted Source).
This response was not seen when participants consumed aspartame — suggesting that your brain may not register artificial sweeteners as having a filling effect (9Trusted Source).
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Another argument against artificial sweeteners is that their extreme and unnatural sweetness encourages sugar cravings and sugar dependence.
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Though observational studies cannot prove cause and effect, the results are sometimes quite staggering.
For example, one study found that a high intake of diet soft drinks was linked to a 121% greater risk of type 2 diabetes (24Trusted Source).
Another study noted that these beverages were associated with a 34% greater risk of metabolic syndrome (25Trusted Source).
This is supported by one study on the effects of artificial sweeteners on both mice and humans. It associated the sweeteners with glucose intolerance and a disruption in gut bacteria (26Trusted Source).
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In fact, replacing sugar with artificial sweeteners may be helpful in reducing body weight — though only slightly at best.
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However, if you experience cravings, poor blood sugar control, or other health problems, avoiding artificial sweeteners may be one of many things to consider.
