Berberine has been called 'nature's Ozempic'. But doctors say it's not worth the risk.

There are hundreds of videos about berberine floating around on TikTok right now. Type the name of the supplement into TikTok's search function and you will find a feed flooded with videos of 'health' influencers documenting '30 days of berberine', influencer physicians talking about how it works, and podcast hosts discussing their own experiences with taking the pills that have been dubbed 'nature's Ozempic' (Ozempic is the brand name for semaglutide, an antidiabetic medication that has been co-opted by the weight loss industry). 

Influencers are touting the promise that berberine suppresses appetite and works as a weight loss tool, much like semaglutide. 

@pokibubble Berberine is apparently natures Ozempic! So obviously we have to try it! Come with me as we try out berberine as a natural weight loss supplement. #berberine #weightloss #weightlossjourneys #naturalsupplements #holistichealth #ozempic #naturesozempic #30daychallenge #berberineforweightloss ♬ original sound - Poki Bubble

One TikToker in particular, @beingsavv, has been drawing thousands of views with the breakdowns of her weight loss statistics, showing off evidence that the supplement has worked for her. 

Berberine is quickly available from online supplement stores at reasonable prices (at least, compared to Ozempic, which has dramatically increased in price, due to a global shortage and now costs approximately $1800 for a three-shot pack without the subsidy in Australia). Containers of berberine pills seem to cost between $25 and $75 dollars for around 100 capsules through online stores. 

But experts are recommending anybody who is considering taking berberine should exercise caution and consult a medical professional before doing so. 

Okay, but what is berberine? 

Berberine is a chemical extracted from the roots of plants and there is evidence that it has been used for more 3,000 years to treat a range of medical issues, including gut issues and infections. 

In recent years, it has had various claims attached to it, including that it can treat diabetes, high cholesterol, burns, liver disease, polycystic ovary syndrome (PCOS), and infections in the digestive tract. 

While semaglutide (Ozempic) is a regulated drug that has been approved for use in people with diabetes, berberine falls under what is known as a 'listed medicine' by the Therapeutic Goods Administration (TGA) in Australia. It's the category reserved for supplements, herbal remedies, vitamins, and complementary medicines. 

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Associate Professor in pharmacology from the University of Sydney, Tina Hinton, tells Mamamia that this means that the TGA doesn't conduct their own safety and efficacy tests, rather, that evidence is provided by companies about their own product. All of this means that berberine is widely available in Australia and consumers can just buy it straight off the shelf. 

Does it actually help people lose weight? 

A meta-analysis of 12 studies, published in Clinical Nutrition ESPEN, shows that berberine, taken daily at the correct dosage, can have modest effects on weight loss (people generally lose around 3kg). 

The strongest weight-loss effects are seen in women with a BMI greater than 30 who take the supplement every day for at least three months, according to another meta-analysis of 10 studies published in Complementary Therapies in Clinical Practice.  

The way that berberine works in the body is actually extremely similar to other diabetes medications and it has a couple of different mechanisms that lead to weight loss. 

Berberine stimulates insulin secretion, which helps to reduce overall blood glucose levels. Associate Professor Hinton says that this has a knock-on effect that seems to prevent the formation of new fat cells, as well as changing the way that fats are stored. 

"There's some evidence to show that [berberine] turns white fats into brown fats and brown fats are actually really important for a bunch of different things but mostly energy regulation in the body," she says. 

Berberine also seems to work by boosting the levels of a hormone in the body that communicates 'fullness' to the brain, increasing the likelihood that people will feel fuller for longer. 

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"The evidence has been evaluated and we can say that it appears that this could be helpful for people who are overweight or have obesity," Associate Professor Hinton says. 

However, these weight loss effects come with a range of potential side effects, including diarrhoea, constipation, gas, disrupting the gut microbiome, and an upset stomach. On TikTok, some of the influencers who are tracking their experiences of berberine report some of these issues. 

Speaking to Medpage, Dr Jamie Kane, director of Northwell Health's Center for Weight Management, said that for many people, looking at these side effects, berberine is "not worth the risk". 

There is also no data to say what happens once somebody ceases taking berberine. 

What do people need to think about if they want to take berberine? 

In his interview with Medpage, Dr Jamie Kane observed that the explosion of TikTok content around berberine came with a "tremendous amount of anti-obesity bias" and he was alarmed by the idea that people are taking berberine based on 20-second clips on TikTok.

Associate Professor Hinton stresses that people should not take on the medical advice of influencers as safe or applicable to them. 

"I think one of the problems with herbal remedies is that you can just go into a chemist and buy it and there's no one to say, 'Don't have more than this' or 'What other drugs do you already take? Because you really shouldn't be having it if you're on these other drugs.' And I think that really is the issue."

Instead, Associate Professor Hinton recommends caution and prioritising healthier decision-making. 

"[Berberine] could be seen as an addition, something else you can add to the mix to help with weight loss but overall, it's about cultivating healthy lifestyle choices, not just about taking a magic pill so you can go and eat whatever you want."

For help and support for eating disorders, contact the Butterfly Foundation‘s National Support line and online service on 1800 ED HOPE (1800 33 4673) or email support@thebutterflyfoundation.org.au. 

You can also visit their website, here.

Image: Getty/Canva