The Ozempic weight-loss craze has spurred interest in a dietary supplement derived from ancient traditional medicine as an inexpensive way to lose weight.
On TikTok, posts mentioning berberine, calling it “nature’s Ozempic,” have racked up millions of views, where some people claim it can help with weight loss and other ailments. Berberine, a bright-yellow compound, can be extracted from the stems, roots, or bark of various plant species.
Traditional medicine in China, India, and the Middle East uses plants that produce berberine as a salve for stings and bites to heal wounds and treat diabetes, infection, and jaundice.
In the US, it is available as a pill or powder from a range of manufacturers, though like other supplements, it isn’t regulated by the US Food and Drug Administration.
Small studies involving people and research in rodents have found that berberine can decrease cholesterol and blood glucose and improve insulin resistance.
The effects of this substance on the nervous system and neurodegenerative diseases like Alzheimer’s and cancer biology are being explored by researchers.
Still, researchers warn that studies linking the supplement to weight loss are limited and that other lifestyle changes, such as exercise and healthier eating habits, might contribute to shifts. The supplement does have mild side effects, including stomach pains, diarrhea, and constipation, but it is harmless for most people, according to doctors.
Kiki Mahoney of Knebworth, England, said she hopes berberine can help her shed a few extra pounds she has picked up since Christmas [1]. She said she bought berberine in tablet form online recently after mentions of its weight-loss benefits flooded her TikTok feed.
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She has been taking a 500-milligram pill twice daily, though she said she doesn’t consider herself overweight and lives a relatively healthy lifestyle. She knew Ozempic was hard to get – expensive, in short supply, and needed a prescription.
It was vanity, she joked. “I like to look nice in my pictures,” she said.
Mahoney, 39 years old, saw people report that berberine, like Ozempic, quieted down thoughts about eating and food. She said her appetite has decreased since taking berberine, and she no longer worries about what to eat for dinner in the morning.
“It could be an absolute placebo, but I have not woken up with those thoughts in my head,” she said, adding that she didn’t consult her physician or feel the need to.
Mahoney saw prices online jump from about $6 a bottle to about $37 since early June. When she saw a bottle sold for $19, she opted for a two-month supply. “It wasn’t a lot of money, and it was worth giving it a try,” she said.
In Cleveland, some of Dr Elizabeth Bradley’s patients who are overweight or obese have experienced moderate weight loss of 5 to 10 pounds over a few months.
“I’m pleasantly surprised at the impact,” said Bradley, medical director at the Cleveland Clinic’s Center for Functional Medicine, about the weight loss in her patients and the drop in cholesterol and blood glucose.
She noted that people taking the supplement might also be making other changes to their lifestyle, which could contribute to the changes.
Bradley first began recommending berberine about six years ago as an antimicrobial supplement for patients who had an imbalance in the population of bacteria in their gut. Eventually, she began recommending the supplement to women with polycystic ovary syndrome, which leads to hormonal imbalance, obesity, and infertility.
Bradley said the supplement improves insulin resistance associated with the condition, where cells decrease how well they respond to insulin. After doing more research, she recently began using it for glucose, cholesterol, and weight concerns, usually recommending 500 milligrams three times a day or with meals.
“I use it judiciously and follow them closely,” she said. People who are breast-feeding or pregnant should avoid the supplement, she added.
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It is a very mild agent, according to Lisa Kroon, a diabetes specialist and professor at the University of California San Francisco School of Pharmacy. “It isn’t going to be the quick fix that people are pursuing in terms of weight loss,” she said.
Kroon said the so-called placebo effect might be at play, where “If you believe it is going to help you lose weight, maybe it does.”
“I’m open but cautious,” she said.
Berberine’s potential weight-loss effects might be initiated in a similar way to the diabetes drug metformin, said Jim Backes, a clinical pharmacist at the Atherosclerosis and LDL-Apheresis Center at the University of Kansas Medical Center. That drug is associated with modest weight loss because it improves how cells use insulin.
Excess insulin in the blood can sometimes make people hungrier, and decreasing insulin levels can reduce that craving, Backes said.
But as far as berberine’s effect on weight loss alone, “The evidence is still weak,” he added.
Evidence about berberine’s health effects from small studies in Asia and Europe have led Backes and his colleagues to test the compound in a US group of patients who have or are at an increased probability of developing metabolic syndrome, a condition characterized by high glucose levels, high blood pressure, high cholesterol, and a wide waistline.
He said this pilot study of about two dozen people will closely watch their glucose and cholesterol and track weight loss and waist circumference.
Backes warned that the quality of berberine supplements varies widely among brands. Of 15 different berberine products sold in the US, Backes and his colleagues found that only six of those products contained at least 90% berberine, they reported in the Journal of Dietary Supplements in 2017 [2].
“With some products, you might get 100%, berberine, you might get 33%, berberine. But then, what’s the other 67%? We don’t always know,” he said. “I would say be very careful.”
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[1] https://www.wsj.com/articles/berberine-natures-ozempic-weight-loss-902e097
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5807210/
