If you’ve spent time scrolling through social media, you may have heard of the supplement berberine, which is being touted as ‘nature’s Ozempic.’ On TikTok, videos describing the benefits of berberine have been viewed 127 million times and include several claims about how it can help you lose weight, lower your cholesterol, and treat insulin resistance. But experts say the benefits may have been exaggerated.
Berberine, which is a bright yellow compound derived from a number of plants—including European barberry and goldenseal—has long been used in traditional Chinese medicine and Ayurvedic medicine for treating issues such as digestive disorders and inflammatory conditions.
Some studies show berberine can improve blood sugar control, lower cholesterol levels, and aid mild weight loss, with an average reduction of approximately between four and five pounds. This fact has prompted people to try it as a replacement for weight loss medications such as semaglutide—the active ingredient in Ozempic and Wegovy; or tirzepatide—the active ingredient found in Mounjaro.
When it comes to using berberine as a replacement for these medications, describing this plant extract as “nature’s Ozempic is overblown,” says Melinda Ring, an integrative medicine physician at Northwestern University Feinberg School of Medicine.
However, although berberine’s impact on weight loss is less effective than new therapies, there is some evidence to suggest that it can have other health benefits.
Weight loss effects are minimal
In terms of weight loss, studies indicate that berberine has, at most, only a very limited effect, leading to a loss “on the magnitude of five to 10 pounds,” Ring says.
In contrast, for medications such as Wegovy or Mounjaro, clinical trials have shown an average reduction in weight of between 30 to 50 pounds, compared to the placebo. The weight loss also happens through a different mechanism, with semaglutide mimicking a hormone that is naturally secreted after food is consumed, which reduces hunger. In contrast, berberine’s mechanism of action for weight loss most likely derives from its effects on blood sugar levels.
If the goal is weight loss, says Dan Azagury, a physician at Stanford University who specializes in treating obesity, the safest, most effective way to accomplish that is to seek out the help of a doctor who specializes in treating obesity. “If you have a heart problem, you go to your cardiologist. If you have obesity, you go to a weight loss clinic that is established and reputable.”
“We’re entering an age where the time for being desperate and trying unsafe things to lose weight is over," says Azagury. "The treatments are here.”
Research is limited
The major advantage of medications such as Ozempic, Wegovy, or Mounjaro, is that they are required to clear a rigorous Food and Drug Administration approval process, which requires a substantial body of research showing a drug is safe and effective. Even after these medications are on the market, they are still monitored, which includes assessing the impact of long-term use. “We do have long-term safety data for GLP-1 agonists like Ozempic,” says Rehman Sheikh, a gastroenterologist at Baylor College of Medicine. “We can’t say the same for berberine.”
For a supplement like berberine, although there have been multiple studies on its effectiveness, these studies have been far more limited in scope, and there is no data on whether it is safe to consume for long periods.
Supplement quality can vary widely
One of the most significant differences between a medication like Ozempic and a supplement like berberine is the method by which it is regulated by the FDA. For medications, drug manufacturers are subject to a number of regulatory guidelines, which includes additional oversight methods for ensuring that patients are receiving a product that is safe, and that contains the stated ingredients and dosage.
In contrast, supplements are considered by the FDA to belong in the same category as food, where the regulatory mechanisms to ensure quality and safety are completely different. The FDA is “not going to control what you eat with the same system as you control with the drugs you take,” Azagury says. To help ensure the quality and purity of supplements, there are a number of independent laboratories that offer outside testing, such as ConsumerLab.com, NSF International, and U.S. Pharmacopoeia.
In her own clinical practice, Ring has suggested berberine to her patients for years, as an additional therapy for managing conditions such as high cholesterol or insulin resistance, or for gastrointestinal issues, such as irritable bowel syndrome.
One potential advantage of berberine is that since it has a different mechanism of action from metformin and statins, it may be useful for patients who don’t respond well to these first-line treatments.
However, although berberine is being promoted as a replacement for statins or metformin, “I would not say that this data is strong enough,” says Nick Milazzo, a researcher for the website Examine.com, which analyzes the health claims of various supplements.
As Milazzo notes, the data from the berberine trials are highly variable, which is often a sign of poor study design. To understand the full effect of berberine, including its potential as an alternative to statins or metformin, more research is needed.
As Ring often counsels her patients, the use of supplements such as berberine need to be approached with caution, and under the guidance of an experienced healthcare practitioner, one who understands what it can be used for, what the best dosing might be, and how it might interact with other medications. “Berberine can be right for some people when used appropriately,” Ring says, “but like anything, it’s not a magic pill.”