Is berberine actually a natural alternative to Ozempic? Here's what to know

Ozempic’s high demand and steep prices have pushed some people into the supplement aisle to browse for weight loss alternatives. Dubbed ‘Nature’s Ozempic,’ berberine is one supplement that people have gravitated toward. But experts say that berberine’s pound-shedding powers are unclear and understudied.^[]

What is berberine? And can it help you lose weight?

Berberine is an extract from plants that has anti-inflammatory properties. It was used in ancient medicine for its antimicrobial benefits, and it might also impact metabolism. Whether or not it goes so far as to induce weight loss is unclear but not unfounded. 

“Berberine is one of those herbs that has been touted to ‘cure everything,’' says Stephanie Redmond, PharmD, CDE, BC-ADM, a nationally recognized diabetes expert and Founder of Dr. Stephanie’s. “However, since we know that metabolic syndrome and insulin resistance are exacerbated by inflammation in the visceral organs, lowering inflammation through berberine use could certainly make a difference in reducing metabolic syndrome symptoms and blood sugar levels through increasing insulin sensitivity,” Redmond adds.

Berberine risks

According to Mir Ali, MD, FACS, FASMBS, bariatric surgeon and Medical Director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center, the most significant risk with patients taking a supplement such as berberine is that it will interact poorly with another substance they are taking. Because of this, providers need to ask patients about all medications they are taking—both prescription and over-the-counter—so that they can best guide and inform healthy decisions.

Dangerous drug interactions could also be a risk if a patient uses a supplement that is altered and contains ingredients other than berberine. This is a common concern with weight loss supplements, doctors told the New York Times, which are often adulterated or contaminated with banned substances. According to the Centers for Disease Control and Prevention (CDC), weight loss substances are the most likely supplements to send people to the emergency room with adverse reactions.^[][]

Berberine benefits

For practitioners, recommending a natural supplement can be a way to establish trust with a patient who is wary of medications, which can be essential for prescribing FDA-approved treatment down the line, Redmond says.

“Medication non-compliance is a real thing, and many patients try natural supplements on their own, so it’s best to be educated or at least have a good resource to check for clinical information so [doctors] can empower the patient to make good decisions,” Redmond says.

Advice for patient use

Redmond says that she likes to recommend natural supplements when relevant and encourages people not to be too dissuaded by the fact that supplements are not FDA-regulated.

“I do recommend berberine because I am a believer in natural dietary supplements,” says Redmond. “It obviously hasn’t been clinically studied to the same great lengths that Ozempic has, although it has been around in the world for a lot longer.”

“My advice to patients is to be realistic [about] natural supplements,” says Redmond. “They don’t work overnight and, just like medications, they don’t work for everyone. You’re not going to lose 100 pounds by starting berberine, but you might see better results versus not taking it at all.”

The main goal of weight loss, regardless of drug, is lifestyle sustainability

Berberine, Ozempmic, or other medications can only do so much when it comes to losing and sustaining weight loss, says Ali. 

“I tell my patients that no matter what we do—surgery, medication, dietary counseling—the whole goal is to help the patient establish a healthier lifestyle,” Ali adds.

This is the most critical component of any weight loss program. While medication or other interventions can help for a period of time, lifestyle changes are most important in helping a person maintain a healthy weight if and when the support goes away, he says.

To ensure that patients are working on lifestyle changes along with taking supplements or medication, Ali advises initial chats with primary care physicians who know the patient’s health history and referrals for more weight loss–specific doctors when needed. What specialist is best will depend on the person’s unique situation and body composition, Ali says. Some specialists could include bariatric surgeons like himself, non-surgical weight loss specialists, and/or dietitians to help educate the patient on what a healthy diet looks like for them, he adds.