By now, you probably know the dangers of drinking sugar-sweetened beverages like regular soda. You’ve surely heard the horror stories about how they’re linked to a laundry list of negative health outcomes, including being overweight, obesity, type 2 diabetes, metabolic syndrome (MetS), neurodegenerative conditions, cardiovascular disease, stroke, dental caries (i.e., cavities), and more. Pretty much, you name it, and you can find a connection to regular consumption of sugar-sweetened beverages.

But did you know that diet sodas sweetened artificially might be just as bad?

According to Susan E. Swithers, a professor of psychological sciences and a behavioral neuroscientist at my alma mater Purdue University, says, “Although it seems like common sense that diet sodas would not be problematic, that doesn’t appear to be the case. Findings from a variety of studies show that routine consumption of diet sodas—even one per day—can be connected to higher likelihood of heart disease, stroke, diabetes, metabolic syndrome, and high blood pressure, in addition to contributing to weight gain.”

Here are 3 potential dangers of regular diet soda consumption.

1. Increased risk of type 2 diabetes and metabolic syndrome. This may seem counterintuitive given that diet sodas are sugar-free. However, research shows that daily consumption of diet soda is associated with a 67% increase of type 2 diabetes and a 36% greater risk for metabolic syndrome (which refers to a cluster of health complications, including high blood pressure, high blood sugar, excess belly fat, and unhealthy blood lipids). On one hand, artificial sweeteners seem to negatively affect gut health, and on the other hand, they may also increase insulin resistance. Both factors impair glucose tolerance.

2. Weight gain and increased risk of obesity. Again, this seems counterintuitive, but mechanistically, it may go hand-in-hand with the increased risk for diabetes and metabolic syndrome. For instance, there’s speculation that artificial sweeteners stimulates the appetite for sweetness and more calorie-dense foods at subsequent meals. Additionally, some people compensate for calories they “saved” by overeating. A classic example is the person who orders a double cheeseburger and a large order of French fries alongside a diet soda. In the San Antonio Heart Study, researchers found that risk of weight gain and obesity (over the course of a 7 – 8-year period) were significantly greater in participants who regularly drank diet sodas compared to those who did not.

3. increased cardiovascular disease and stroke. The most recent strike against diet sodas comes from a study published in the American Heart Association journal Stroke. Researchers found that drinking diet soda daily resulted in a 3-fold increased risk for dementia (including Alzheimer’s disease) and stroke compared to folks who don’t drink diet soda. Although this has been the talk of the town recently, several previous studies have found an increased risk of coronary heart disease, heart failure, heart attack, and stroke associated with diet soda consumption.

Considering that at least 20% of Americans drink at least one diet soda every day, we think the figurative writing is on the wall. “’Are diet sodas worse for you than regular sugar-sweetened sodas?’ I think that’s the wrong question,” says Susan E. Swithers. The real question: “What good are sodas for you in the first place?”