When Savannah Crosby started posting videos on TikTok about using berberine, a dietary supplement, for weight loss, she had about 500 followers.
About two months later, Crosby now has more than 21,000.
“I have a lot of joy and gratitude over the fact that sharing my experience has been able to help other women with the same struggles that I have” in trying to lose weight, said Crosby, a 34-year-old who lives in San Antonio and works for a property management company.
Crosby’s popularity is part of a larger trend. People have nicknamed the supplement, which can be purchased online and at convenience stores, “nature’s Ozempic”, referring to the prescription drug that has also received significant attention because of its effectiveness at helping people shed pounds.
Since Ozempic is expensive and can be difficult to obtain, it appears some consumers have instead turned to berberine. On TikTok, videos about the supplement have generated more than 92m views.
But physicians and dietitians caution that there is little evidence that berberine can actually help people lose weight and that the long-term effects of using it are unclear.
In short, they say, berberine may just be the latest weight loss fad.
“People see a little bullet, something that” they think “might help, and it catches on, and it’s huge for a short period of time, and then it kind of goes away”, said Deborah Cohen, a registered dietician and associate professor in the Rutgers University Department of Clinical and Preventive Nutrition Sciences.
Berberine comes from the root and bark of several plants and has been used in China as a medicinal herb since ancient times, according to a study in the Frontiers in Physiology journal.
Weight loss is, of course, always a big topic of discussion in the United States because 41.9% of the population is obese, according to the Centers for Disease Control and Prevention.
Crosby found an article about berberine while conducting research to determine whether insulin resistance might have been why she was eating healthy but not losing weight.
“That signaled to me that there’s something going on with my body,” Crosby said of the lack of results.
A report in the journal Clinical Nutrition Espen states that “obesity-induced inflammation can exacerbate insulin resistance” and that “berberine has anti-inflammatory effects”.
Crosby said she would have asked her doctor for Ozempic but she had dropped her health insurance because of its cost. Even if she had coverage, many insurers won’t pay for the drug, which can cost more than $900 a month, according to GoodRx.
Instead, Crosby paid $24 for a three-month supply of berberine.
But it’s “not comparable, in any way, shape or form”, to Ozempic, said Dr Pieter Cohen, a Harvard Medical School associate professor who studies supplements.
There is significant evidence that Ozempic not only leads to weight loss but that it reduces the risk of health issues like diabetes, heart disease or strokes, Cohen said.
A New England Journal Medicine study of semaglutide, the generic name for Ozempic, featured almost 2,000 people with obesity and found that those who took the drug and made lifestyle changes lost 15% of their body weight in 68 weeks.
Studies of berberine have generally only lasted one to three months, feature less than 70 participants, and typically do not measure its effects on body weight, according to a review published in the journal Clinical Nutrition Espen.
“Obesity is a chronic disease, and three months is a very short amount of time. In order to know if there’s really any lasting effects, the studies need to be much, much longer,” said Deborah Cohen.
Even if studies did have a bigger sample size and longer duration, people would not necessarily be able to purchase the same berberine used in the research because it’s a supplement rather than a pharmaceutical drug, said Cohen.
While the Food and Drug Administration closely monitors prescription drugs, the agency provides little scrutiny over dietary supplements, so “companies put whatever amount” of berberine “they want into the products, and no one is checking to make sure that the amount is accurately listed on the label”, Pieter Cohen said.
People on TikTok are also discussing the comparisons between berberine and metformin, a drug used to treat high blood sugar in people with diabetes. Like metformin, berberine reduced insulin resistance when it was tested in obese rats; though further studies are needed to evaluate the impact of berberine on people with type 2 diabetes, according to a study in the journal Metabolism.
Renee Carthan, a high school Spanish teacher in Lake Charles, Louisiana, turned to berberine in October 2022 after gaining “about 65lbs” in one year. She didn’t want to take Ozempic because she had tried a different prescription weight loss medication that ultimately wasn’t effective and she didn’t like how it made her feel.
She also didn’t want to worsen an earlier shortage of Ozempic, which is also a diabetes medication, and potentially make it more difficult for people like her father, who has type 2 diabetes, to obtain the medicine. (There is no longer a shortage of the drug, Reuters reported in March.)
Her doctor told her about vitamins and supplements that could help her lose weight. In October, she started taking vitamin D, magnesium and berberine supplements and continued to exercise. She weighed 212lbs; now she weighs 184, she said.
“I feel great,” she said. “It’s a full-circle thing. I have more energy, which makes me want to work out more. It’s helped my confidence.”
Despite such stories of weight loss, physicians and dieticians remain concerned because they say they don’t know the long-term effects of using berberine.
Scientists still don’t know if the weight loss will last or if the weight loss from berberine is safe, Cohen said.
Crosby, the TikTok influencer, has lost 8lbs in eight weeks, she said. Her clothes fit her differently and she has less of an appetite.
She has received comments from people on social media who also have seen the scale finally moving. Others have said they experienced headaches, bloating and vomiting on the supplement. For anyone who’s interested in berberine, Crosby advises people to talk with their doctor.
“Don’t just start taking things because they become very popular,” she said. “I wish [berberine] could help everybody, but obviously we have to be careful and remind ourselves that it might not.”
This article was amended on 12 June 2023 to clarify that Ozempic is not solely used for weight loss.
