Can Xylitol Help You Lose Weight?

Dr. Christopher McGowan
February 24, 2021

There is no way around it—Americans are addicted to sugar. On average, we eat 2-4 times the recommended amount of sugar every day, and this trend is having drastic effects on our waistlines

As the effects of increasing sugar consumption become more and more apparent, the search for alternative sweeteners continues. For the last century, we have been looking for ways to get the sweet taste we crave without the weight gain that can come from eating too much sugar. The promise of great taste without the calories sounds attractive but how safe are these sugar substitutes?

What is Xylitol?

Polyols are a little known, naturally occurring family of compounds found in many kinds of fruit. These sugar alcohols can also be produced by industrial processes using corn or other agricultural byproducts. Though not traditionally consumed as a natural sweetener like stevia leaves, recently polyols have begun to crop up in a growing number of places. 

Polyols are a family of compounds that contain several different chemicals used in food production. Of these chemicals, erythritol and xylitol are the most widely recognized, and chances are you may already be consuming them without knowing it. The complete list of polyols is long and includes some of the following:

  • sorbitol
  • xylitol
  • mannitol
  • maltitol
  • erythritol

Sugar alcohols such as xylitol have a place as low-calorie sweeteners, but they are commonly used in candies and sugar free chewing gum. Due to the potential for causing diarrhea and other gastrointestinal discomfort, sugar alcohols are used less in food than other alternative sweeteners like agave, stevia, or even artificial sweeteners. 

Xylitol in particular is known to have a cooling aftertaste that makes it an easy choice for anything minty. It is also commonly used in sugar-free ice cream and is often included in other products like toothpaste.

Unlike chemically derived artificial sweeteners such as saccharin or aspartame, xylitol is a naturally occurring compound. Even if you aren’t eating a diet that contains xylitol as a food additive, you still have it in your body. As a byproduct of metabolism, your body produces xylitol on its own. This does not mean, however, that your intestines are expecting to get more xylitol in your food. 

Can Xylitol be Bad for You?

Just because your body produces this sugar alcohol, that doesn’t mean it is necessarily a great thing to add to your diet. There are several possible downsides to consuming too much xylitol. The most common, and potentially most embarrassing of these effects is diarrhea. 

Sugar alcohols are not readily digested by your body, and they make it through your small intestine unscathed. As your food reaches your colon, your large intestine will draw water out of surrounding tissue in an attempt to digest sugar alcohols like xylitol. This process, called osmotic diarrhea, has a laxative effect as the extra water loosens your stool. 

For most of us, getting the runs from something we ate may just be a bit inconvenient, but for some people, this can be a genuine problem. Diarrhea and the consequent dehydration can be dangerous for the elderly and other people who have certain health conditions. It can also be potentially lethal for individuals who have undergone gastric bypass surgery and no longer have the ability to take in large volumes of liquid. Losing water into your stool, then attempting to replace those liquids with a diet soft drink containing more sugar alcohols, can create a dangerous, vicious cycle. 

Though sugar alcohols are included in many different products marketed to help you lose weight, the evidence is not conclusive that swapping regular sugar for xylitol will help you drop the pounds. Eating or drinking large amounts of sugar alcohols can cause changes in your gut biome and glucose tolerance that can be linked to weight gain. What is more, since your body does not get as many calories from alternative sweeteners, you may end up eating more food since you don’t feel full as rapidly.

The Benefits of Xylitol

Dropping sugar from your diet not only helps your waistline, but it can be a benefit to your teeth as well. Getting the sugar out of your diet will help prevent tooth decay, but replacing sugar with xylitol as a sweetener takes the beneficial effects for your oral health even further. Research has shown that consuming xylitol can cause changes in the bacteria in your mouth, potentially reducing levels of Streptococcus mutans and Streptococcus sobrinus, two bacteria linked to plaque formation. 

One of the main reasons people include sugar alcohols in their diet is to help control blood glucose levels. Sucrose, the chemical in table sugar, has a glycemic index of 65 out of 100, and consuming large amounts of sugar can lead to rapid spikes in blood sugar levels. Xylitol, on the other hand, has a glycemic index of 7, which means swapping it out for regular sugar will allow you to still get the sweet taste you are looking for in the foods you love without the spike in blood sugar that can follow. 

High blood sugar levels lead to increased insulin levels as your body tries to frantically store the energy-rich glucose in your blood as fat. Maintaining high levels of dietary sugar can eventually lead to insulin resistance and eventually to type 2 diabetes. 

Sugar alcohols are particularly useful for people who are diabetic and need to maintain a close eye on their blood sugar. Since xylitol, stevia, and other natural sweeteners like agave do not cause the same spike in blood sugar that sucrose or high-fructose corn syrup can cause, they are attractive to people who are living with the challenges of type 2 diabetes.

People who are concerned about regulating blood sugar are not the only ones who can benefit from alternative sweeteners. Anyone who has tried a low-carb or keto diet knows that sugar cravings can be a real threat to dietary success. Avoiding all carbohydrates to keep your body in a state of ketosis where the fat is being burned for energy means regular sugar has to go. Finding low-calorie or zero-calorie alternative sweeteners is essential if you can’t quite shut down your sweet tooth while you try to stick with your low carb diet. 

How Much Xylitol is Bad for You?

Roughly 20-45 grams of xylitol is the generally accepted limit for a single dose depending on your body size and overall tolerance to the effects of xylitol. Some people will experience gastrointestinal side effects more readily, and as a result may want to consume smaller amounts of sugar alcohols or avoid them altogether. 

Is Xylitol an Appetite Suppressant?

Xylitol is considered a sugar substitute, but far from being an appetite suppressant, it may cause you to eat more. Eating regular sugar, and the consequent spike in blood sugar that follows, are part of your body’s natural mechanism of satiety, or the feeling of fullness that tells you when to stop eating. By replacing sugar with non-nutritive sweeteners such as sugar alcohols, you may not feel full as quickly, which can lead to overeating. 

Can Sugar Alcohols Help You Lose Weight? 

The bottom line in low-calorie sweeteners and weight loss is this: if you are looking to lose weight, cutting the sweets in all forms is the best bet. Simply replacing the sugar in your soft drinks with other artificial sweeteners is not likely to help you lose weight. Even though picking versions of sweets made with sugar alcohols or stevia may provide you with fewer overall calories than the sugary versions, there is more to the story. Potential disruptions to the microflora in your gut, inflammation reactions, and the chance you will overeat can offset the gains you might have from eating fewer calories. 

If you are serious about losing weight, it is going to take planning, discipline, and maybe even some help along the way. At True You Weight Loss, we know how hard it can be to start losing weight. Especially at the outset, some people find it nearly impossible to navigate the complexities of changing their diets and lifestyles to get set up for success. Our medical nutrition therapy program can do just that for people who are struggling to get their bearings at the start of a weight loss journey. 

For a small number of us, keeping to a severe diet and exercise plan still isn’t enough. In these cases, it may be necessary to consider a different form of intervention such as Spatz3, the ORBERA® Managed Weight Loss System, or even a minimally invasive procedure such as an endoscopic sleeve gastroplasty. These procedures can lower the available size of the stomach, which reduces the raw amount of calories you can consume in a day. If you have been struggling to gain traction in your plans to lose weight, and have been living with obesity for years, request a consultation with us today to see if this might be a path finding the freedom from excess body weight you have been searching for.

Dr. Christopher McGowan
Dr. Christopher McGowan

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

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