Swapping diet drinks for water linked to greater weight loss and diabetes remission in women

From healio.com/news

Key takeaways:

• Replacing one diet soda per day with water was linked to increased weight loss.
• Many women who swapped diet beverages for water also achieved type 2 diabetes remission.

CHICAGO — Women who replaced their lunchtime diet beverage with water had greater weight loss and achieved diabetes remission compared with women who continued drinking diet beverages, according to new research.

Hamid R. Farshchi, MD, PhD, CEO of D2Type and former associate professor at the University of Nottingham School of Life Sciences, U.K., presented a randomized study at the American Diabetes Association Scientific Sessions evaluating the metabolic benefit of substituting water for diet beverages among women with type 2 diabetes and overweight or obesity.

Drinking water at lunch was tied with greater weight loss and higher odds for diabetes remission vs. drinking a diet beverage. Image: Adobe Stock

“Patients often assume diet sodas are a ‘free pass’ because they contain no calories. Yet evidence on weight and glycaemic control is inconsistent. We wanted a clear, long-term test of whether simply swapping diet beverages for water could shift the needle in everyday practice,” Farshchi told Healio.

The researchers enrolled 81 women in an 18-month weight management program who reported regular intake of diet beverages. The women were randomly assigned to replace the diet beverages with water or continue usual intake of five diet beverages per week after lunch.

“Women make up the majority of commercial weight-loss program participants and show distinct hormonal and behavioural responses to sweet tastes,” Farshchi told Healio. “Keeping the cohort single-sex reduced variability and let us achieve adequate power with our resources.”

The 18-month weight program consisted of a 6-month weight-loss program followed by a 12-month weight-maintenance program.

By the end of the 18-month weight program, women assigned to water had greater mean weight loss compared with the diet beverage group (6.82 kg vs. 4.85 kg; P < .001).

“The open question was, would people with type 2 diabetes — who often have stronger sweet cravings and insulin resistance — stick with plain water for 18 months? We expected some benefit, but the extra [approximately] 2 kg weight loss and higher remission signal in the water group were larger and more durable than we dared hope,” Farshchi said.

Ninety percent of women assigned to drink water achieved diabetes remission compared with 45% in the diet beverage group (P < .0001), according to the study.

The researchers also observed improvement in BMI, fasting glucose, insulin levels, insulin resistance, postprandial glucose and triglycerides among women assigned to drinking water.

“The advice is refreshingly simple: Encourage patients who lean on diet sodas to try water instead,” Farshchi told Healio. “It’s free, improves overall calorie control and may boost diabetes-remission odds. Embedding ‘water first’ into lifestyle counselling could be low-hanging fruit for better outcomes.” 

https://www.healio.com/news/endocrinology/20250622/swapping-diet-drinks-for-water-linked-to-greater-weight-loss-diabetes-remission-in-women