Why the Supplement Berberine Is Not 'Nature's Ozempic'

Barberries, of the Berberidaceae family, are a common natural source of berberine. Credit - Volga2012—Getty Imagegs

Social-media platforms like TikTok are full of people conducting their own one-person trials of what they’re calling “nature’s Ozempic.” The oral supplement berberine, a compound found in turmeric and several other plants, can dupe the appetite-suppressing and weight-loss effects of the popular injection, they say—but without a prescription, high copay, or shot.

The only problem is that there’s really no such thing as “nature’s Ozempic,” because Ozempic is far from natural. Semaglutide, the active ingredient in Ozempic, Wegovy, and other prescription drugs, works in the body by imitating a hormone called glucagon-like peptide-1, or GLP-1, which is produced in the gut after eating and prompts the production of insulin. This makes semaglutide a great treatment for Type 2 diabetes and a promising one for weight loss, since it also mimics the feeling of fullness. But berberine just doesn’t work the same way.

What is berberine?

The plant-derived supplement comes from barberry shrubs and a number of other bushy plants. It has been used in traditional alternative medicine since its first documented use in China in about 3000 B.C. Berberine has garnered attention from researchers, who have looked into the compound as a potential way to help manage Type 2 diabetes.

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Some clinical trials have found that taking berberine can help reduce blood glucose levels and improve a number of cardiovascular health markers, mimicking some of the effects of the widely used diabetes medication metformin. The two have shown promise when used in tandem. Berberine has also been found to reduce insulin resistance, which is a secondary effect of semaglutide. But berberine cannot replicate the key mechanism of semaglutide and bond to GLP-1 receptors, making it a poor stand-in for drugs like Ozempic.

Read More: Ozempic Exposed the Cracks in the Body Positivity Movement

Berberine can result in some modest weight-loss. A 2020 meta-analysis found that when people took about 500 mg of berberine daily, they lost just about four pounds on average, even when sticking with the regimen for months. That’s a paltry amount compared to semaglutide, which can cause users to lose an average of 12% of their weight in around six months. “There is a marginal benefit from berberine supplementation on total body weight, but the benefit is nowhere near weight loss medications, and nowhere near any real amount of weight loss that would be required for any significant health changes,” says Dr. Idrees Mughal, a British physician with a masters in nutritional research.

The risks of taking berberine

But even if you’re only looking to shed a few pounds, there’s no guarantee berberine will help. Like any supplement, it comes with potential risks, and Mughal suggests that anyone interested in taking it consult with their doctor about potential interactions with medications or risks tied to health conditions. Because it’s a supplement, berberine is not regulated as strictly as over-the-counter and prescription drugs, so the only way to know that what you’re purchasing is accurately labeled in ingredients and dosage is to ensure that a brand’s product has been certified by a third-party organization like NSF.

Berberine users face more risks than those shared by all supplements sold in the U.S.: This particular supplement tends to cause a lot of diarrhea. Though the exact reasons for this are unknown, Mughal suspects that it may be related to how the compound reduces glucose levels in the body. When glucose transportation across the gut is decreased, more water and sugar is left in the digestive system, which can lead to gassiness and related issues. (This is believed to be one of the reasons why semaglutide medications can also cause gastrointestinal distress.)

Diarrhea can lead to marginal weight loss in multiple ways—not just by getting rid of what’s in the bowels, but also because people may feel too uncomfortable to want to eat. Mughal compares this to taking shots of apple cider vinegar, another popular weight-loss trick that works because pouring vinegar into an empty stomach tends to make people too nauseated to eat. This is akin to laxative-based dieting, which is not the same as a true appetite suppressant and is much more taxing on the body.

The bottom line on berberine

Considering berberine’s laxative effect, the placebo effect, and the fact that most adults’ weight tends to fluctuate a few pounds here or there for any number of reasons, it’s easy to see how berberine might be getting a lot more credit than it’s due. What’s more, most of the weight-loss studies on berberine only include people who are already changing other important habits like diet and exercise.

“People need to realize that weight-loss medications that are prescribed are completely different from supplements,” says Mughal. “With true weight-loss medications, you can literally just take the medication, not do anything else, and you will lose weight.” But many supplements rely on other changes, like diet and exercise, to have any real effect. “Just taking berberine by itself, without addressing anything else, is likely not going to do anything,” he says.