Flavored Water Has Officially Taken Over TikTok—but It May Come With Some Hidden Dangers, According to Experts
Candice O’Lena was scrolling through TikTok in May when she happened upon what seemed to be a genius idea: WaterTok.
If you've been too underwater this year to wade into social media fads, here's a quick primer on this one: "WaterTok is a trend on TikTok providing different recipes for flavored water to encourage people to drink more water and less sugar-laden beverages," says Beth Czerwony, RD, a registered dietitian from Cleveland Clinic’s Center for Human Nutrition.
O'Lena loved the idea.
"I am on a weight loss journey, and I struggle to get enough water in every day. I thought, ‘This is great. I'll drink flavored water,'" O'Lena says.
O'Lena tried to recreate what she saw in WaterTok-related TikTok videos, some of which have been racking up millions of views. She created a water station with fun-looking, colorful packets. She started putting five to six packets per day—sometimes more—into the water, which she put in a 40 oz. Stanley Tumbler (another hallmark of WaterTok videos). Even her husband got in on it.
On Mother's Day, O'Lena, a mother of two, celebrated with a mimosa. The next day, she says she started feeling really sick.
"I was in and out of the bathroom all day," O'Lena says.
Then, O'Lena started throwing up at work. She couldn't leave the house. Her mother came over to help care for her children. She feared it was a side effect of Ozempic, perhaps exacerbated by alcohol. But then her husband, who isn't on Ozempic, started getting sick too.
“We were like, ‘What is going on why are we getting really sick, but our kids, who get every germ, are not?’” O'Lena says.
O'Lena started looking into the contents of the water packets. What stood out: aspartame, an artificial sweetener found in diet sodas, which O'Lena has enjoyed in moderation without issue. When O'Lena was well enough to go back to her doctor, the doctor confirmed the amount of aspartame was likely the root of her GI issues.
O'Lena posted about her experience on TikTok. But her story is a vastly different flavor from many of the videos touting the trend. The aesthetically-pleasing nature of water bars—with pumps and bright-colored packets—is tailor-made for the TikTok era.
“It’s supposed to be fun," says Dr. Nate Wood, MD, a Yale Medicine internist. "You have this huge water bar with these pumps and packets. You get to mix it yourself. You feel like a mixologist." But, explains Janelle Connell, RDN and personalized nutrition expert at Viome, the aspartame contained in these packets can cause harmful side effects. "Aspartame and other artificial sweeteners can cause GI issues such as bloating, nausea, diarrhea, cramping and flatulence," she explains. "Aspartame hurts the gut microbiome and has been associated with obesity, Type 2 diabetes and metabolic syndrome."
This is unfortunate, she notes, since these are the health areas that artificial sweeteners (by replacing sugars and lowering total caloric intake) are intended to support. "Aspartame has also been shown to disrupt gut microbiome communication (quorum sensing), thus promoting the progression of long-term digestive diseases such as irritable bowel syndrome."
Though the WaterTok recipes tout being "zero-sugar," they have artificial sweeteners like aspartame, which experts confirm can cause diarrhea if you're sensitive to it.
It also turns out there are numerous potential issues with WaterTok recipes including their place in diet culture. It's essentially mixing up the idea of what's water and what's soda, and doctors don't recommend you drink up.
Two dietitians and a doctor spilled what to know about WaterTok before trying it.
Related: Here's What People Actually Mean When They Talk About 'Gut Health'
What Is WaterTok?
WaterTok combines the word "water" (for water recipes) and "TikTok" (where it's created a buzz).
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One video with more than 4.5 million views comes from influencer Tonya Spanglo, who has one million TikTok followers and is largely credited with making WaterTok happen. In the video, she's about to make her second WaterTok recipe of the day. Spanglo reaches into a cute woven basket and pulls out a packet with pineapple flavoring.
"One of my faves," she says before heading over to her "water bar" full of aesthetically pleasing bottles of syrup traditionally found at an actual bar to add coconut syrup.
And while WaterTok may be a new term, the concept is not new.
"The flavored water trend seems to have a connection to the post-operative community as well as to the weight loss community, and it's not too hard to imagine why," says Maddie Pasquariello, MS, RDN. "After many surgeries, including bariatric surgeries like gastric surgery, patients are typically told to avoid eating certain foods and avoid drinking certain liquids, including carbonated drinks like soda."
Why Is WaterTok Trending?
Spanglo jumped on the trend partly because she dislikes plain water—a common motivator for other people sipping WaterTok these days, Pasquariello says.
"There are a surprising number of people who don't love the taste of plain water or for whom, for whatever reason, drinking enough plain water in the day is a challenge," Pasquariello says, adding that it's normal to struggle to remain hydrated.
But WaterTok makes it fun. Speaking of fun, the names of the WaterTok recipes are fun: unicorn cotton candy water, banana split water and salted caramel water are a few of the long menu of options.
Related: Honey Might Lower Blood Sugar, According to a Study
Why Too Much Flavor-Enhanced Water Isn't a Good Thing
As O'Lena said, aspartame is also found in diet sodas. It begs the question: Is there really a difference? The answer to that question is also complicated, as WaterTok recipes mirror diet sodas.
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Another video from @teachwithmx hits multiple spaces on my 2023 trend bingo card: WaterTok, Stanley Tumblers and Taylor Swift. The user is headed to see T-Swizzle, but not before filling her tumbler with Orange Crush-flavored water.
Yes, Orange Crush, as in the soda flavor. But is it different than soda? Not really.
"The artificial sweeteners from diet sodas are the same as those found in flavor enhancers, so if you don’t tolerate those well, you won’t have better results," says Czerwony. "Most products contain aspartame."
Dr. Woods adds that the packets also contain artificial colors and flavorings, similar to soda. The big difference? They aren't carbonated.
"Carbonation isn’t ‘unhealthy,’ but it makes it more acidic, so it’s worse for our teeth," Dr. Wood says. "But to our bodies, it looks very much the same."
Aspartame, Ozempic and Alcohol...Oh My?
But was it really just the flavor enhancer that made her sick? She was on Ozempic and had a drink, in addition to using at least six packets of flavored packets in her water daily. Was it, combined, a recipe for massive GI upset, or can we pinpoint aspartame?
The doctor who actually treated O'Lena believes it was the aspartame. The experts Parade spoke to made it clear they can't personally give further insights into O'Lena's condition—they don't treat her and so it's not ethical to say.
What Pasquariello can say is that it's complicated.
"Speaking purely about the elements in question here, scientific literature looking at the link between aspartame intake and digestive symptoms has been very mixed," Pasquariello says. "Some studies suggest there might be a correlation between the two, while others are inconclusive.”
Indeed, a 2021 study of artificial sweeteners, including aspartame, indicated that it could disrupt the microbial gut balance. These findings run in contrast to studies cited in a 2019 review, which didn't find aspartame had significant impacts on the gut.
Dr. Wood shares concerns about long and short-term effects on the gut, however.
"Long-term, we think that aspartame may change the types and amounts of bacteria in the gut," Dr. Wood says. "It’s unclear what effects these bacteria changes may have long-term. Short-term physical symptoms of consuming aspartame include nausea, stomach upset, bloating and diarrhea.”
That's what O'Lena experienced. But Ozempic also lists nausea, vomiting, diarrhea and stomach (abdominal) pain among its potential side effects. And what about when mixed with alcohol? Dr. Wood says Ozempic can slow down the processing of alcohol because the drug also slows down the rate at which the stomach empties its contents into the small intestine.
"Alcohol starts to be absorbed into the bloodstream directly from the stomach before it even reaches the small intestine," Dr. Wood says. "So in a person who is taking Ozempic compared to a person who is not, the alcohol may spend longer in the stomach to be absorbed into the bloodstream before being emptied into the small intestine, where the rest of it is digested and absorbed."
Again, neither can comment on O'Lena specifically. But Pasquariello recommends doing exactly what O'Lena did.
"If you are experiencing distressing symptoms after making any sort of diet or lifestyle change, you should seek medical attention," O'Lena says.
How Much Is Too Much?
Pasquariello says that consuming one WaterTok recipe doesn't pose a huge risk. But regular consumption of artificial sweeteners—whether in soda, food or WaterTok—does.
"Higher consumption of artificial sweeteners has been linked with certain cancers as well as to obesity, high blood sugar, heart attack, cardiovascular disease and cerebrovascular disease,” Pasquariello explains.
All of these longer-term risks are in addition to the short-term GI issues.
Another problem: It's challenging to pinpoint precisely how much aspartame someone consumes per flavored packet. There's a reason for this:
"The manufacturers of aspartame-containing drink mix products...are not required to list the aspartame by weight in milligrams on their labels," Pasquariello shares.
Pasquariello says she can give a rough estimate.
"A 1-gram packet of Equal contains 37 mg. of aspartame, and diet sodas contain around 100-200 mg. per 12 oz. serving," Pasquariello explains. "It is reasonable to assume the amount of aspartame in the majority of these single-serving drink mix packets—which all vary by weight but is typically between 1-3 g. each—is somewhere in the middle of 37 and 200 mg. of aspartame."
It's a wide range and rough estimate, but: "someone consuming around eight 12-oz cups per day, or 96 oz., with a single drink mix per cup could be consuming around 800 mg, but possibly more or less," Pasquariello says.
That number (96 oz.) is fairly close to what some of the major influencers partaking in WaterTok are consuming. Spanglo told Vox in an interview that she had already finished 80 oz. of flavored water daily using WaterTok recipes by 4 p.m.—and she was drinking another 40 oz. a tumbler that would bring her daily total to 120 oz. Another person, Haley Staggs, 21, told TODAY.com that she drinks 100 oz. of flavored water daily.
It's a lot of numbers, and none are the precise amount. Whether they're consuming a little more or less than 800 mg of aspartame with their water daily, it's clear it's far more than having a Diet Coke at lunch.
Related: Can Apple Cider Vinegar Help With Blood Sugar Control?
WaterTok and Diet Culture
Beyond the physical effects, there's another insidious reason why doctors may not be a fan of WaterTok. Copious water consumption and use in weight loss have gone hand in hand for some time.
"It's a tried and true method of diet culture to encourage people to drink water so they don’t feel like eating," Dr. Wood explains. "People may buy into the idea, ‘I can drink all of this water because it tastes so good, and it’s fun and exciting. Then, I won’t have to eat.’ That mantra is concerning, especially for people vulnerable to that."
It also reinforces the idea that there are "good" and "bad" foods.
"Lusting after certain foods and feeling like culture says those are bad or unhealthy foods you aren’t allowed to have," Dr. Wood says. "You get into this habit of having some foods as good and others as bad…it plays into that. It’s a big concern. It’s complicated."
Other Ways To Shake Up Your Water Consumption
Staying hydrated is recommended. But it can be a challenge if you really can't with plain water or are simply so on the go that you forget, Pasquariello concedes.
"Keep water near you," Pasquariello suggests. "It seems obvious, but having a big water bottle or carafe with you as you work is a good way to ensure you're not running out and that you don't have to re-fill your cup every time it's empty."
Instead of aesthetically pleasing water bars, opt for a cool glass that stands out in a sea of Stanleys (or opt for the Stanley you've had your eye on).
"It’s always encouraging to drink from something that gives you joy," Czerwony says. "Find one that is insulated—you may enjoy cold water versus room temperature."
Finally, Dr. Wood suggests adding whole fruits and fresh herbs to water instead of flavored packets, such as:
Muddled mint
Juice from a fresh orange, lemon, grapefruit or lime
Cucumber slices
Fruit cubes "Freeze a couple of berries…it gives it color and flavor," Dr. Wood suggests.
If you're concerned about hydration and its effects on your health, speak with a healthcare provider. O'Lena has adapted one of Dr. Wood's suggestions since speaking with her actual healthcare provider.
“I went back to drinking plain water with lemon," We’ve been fine ever since. “Just because it stays it’s sugar-free doesn’t mean it’s good for you, healthy or the best choice. If you’re trying to get water in, there are other options.”
Next up: Diet Coke Vs Coke Zero: Which One's Better for You?
Sources
Beth Czerwony, RD, a registered dietitian from Cleveland Clinic’s Center for Human Nutrition
Dr. Nate Wood, MD, a Yale Medicine internist
Janelle Connell, RDN and personalized nutrition expert at Viome