2025: https://www.sciencedirect.com/science/article/pii/S126236362...
2023: https://pmc.ncbi.nlm.nih.gov/articles/PMC10465821/
To address your point: Potential for reverse causality cannot be eliminated; however, many sensitivity analyses were computed to limit this and other potential biases
2023: Clinical review https://pmc.ncbi.nlm.nih.gov/articles/PMC10822749/
multiple studies have shown various side effects associated with the use of these sweeteners. These side effects include gastrointestinal symptoms [9], neurologic [10] and taste perception changes [11], allergic reactions [12], insulin and metabolic effects [13], and cardiovascular effects [14]. In addition, ASs have been shown to affect the gut microbiota that may mediate certain side effects [15]. Most importantly, many researchers have assessed the potential effect of ASs on the cancer risk of people who consume these products [16,17].
and
Human studies performed by Suez et al. evaluated the impact of ASs on the human microbiome. A total of 381 individuals without diabetes who self-reported regular consumption of ASs, as determined by a food frequency questionnaire, were included. The study demonstrated a significant association between the consumption of ASs and the development of central obesity, elevated fasting blood glucose levels, increased hemoglobin A1c levels, impaired glucose tolerance, and elevated alanine aminotransferase levels. In addition, a subgroup analysis was conducted to compare those who consumed higher amounts of ASs with those who did not consume any ASs. The results of this analysis revealed a statistically significant elevation in hemoglobin A1c levels, even after controlling for body mass index.
They outright state this. The first directly says that their higher sugar substitute group had a higher BMI, lower activity, less fibre, and so on.
"To address your point: Potential for reverse causality cannot be eliminated; however, many sensitivity analyses were computed to limit this and other potential biases"
I've actually read the study (given that certain sorts cite it constantly), and do you know what "limited" that bias? Nothing. Literally nothing.
It is a correlation study. People with weight problems are more likely to utilize sugar substitutes. Reversing the causation is the root of an enormous amount of idiot science, though.
And just to be clear, researcher who post this bunk know exactly what they're doing, and usually it is to yield a "more research should be done" conclusion. It's when laymen start building their little notepad.exe listing of everything that supports their nonsense that it becomes a problem.