Key Points

• Berberine supplements may offer modest weight loss of about 4-5 lbs
• People lost an average of 15% of their body weight on Ozempic, an FDA-approved drug to treat type 2 diabetes
• Berberine does not work like Ozempic. Both have been shown to lower blood sugar levels but in completely different ways
• Any weight loss medication or supplement also needs a healthy diet and regular exercise to sustain the weight loss and control blood sugar

Americans spend over $33 billion on weight loss products and services each year. Yet obesity rates keep climbing, with over 40% of US adults now classified as obese.

In recent years, Ozempic and similar medications have helped people lose weight, reduce their appetite, and control their blood sugar.

What’s more, these weight loss drugs are changing the conversation around weight gain. More people are starting to understand that weight gain is about metabolism, not willpower.

Now, there’s a huge demand for weight loss solutions that work, but the reality is that Ozempic is not for everyone.

When Ozempic is not an option

Getting access to Ozempic involves meeting certain health criteria, obtaining a doctor's prescription, and navigating insurance coverage (it’s very expensive out-of-pocket).

Plus, many prefer not to jump into injectable medications, wanting to try potentially simpler options first.

For these reasons and other factors, some people are looking into berberine, a natural compound that might help lower blood sugar, support weight loss, and offer additional benefits.

So, how does berberine really stack up against Ozempic? Let's break it down.

What is berberine?

Berberine is a bright yellow compound found in several plants and has been used in traditional Chinese medicine for centuries to treat various ailments. In recent years, modern research has been looking into berberine for its effects on metabolism.

In early and limited studies, berberine supplements helped:

• Lower blood sugar levels
• Lower “bad” cholesterol and triglyceride (fat) levels
• Reduce inflammation

How it works

Berberine is believed to activate the body’s energy manager called AMPK.

The body, particularly the brain, needs a constant stream of glucose for energy. When energy levels are low, AMPK is triggered into action. It helps your body burn stored sugar and fat for energy.

AMPK also allows your muscles to absorb more glucose from the blood to fuel up, making your cells more sensitive to insulin. (Fun fact: exercising also helps trigger AMPK).

So, berberine’s weight loss benefits may stem from the fact that it helps reduce insulin resistance. Ozempic, on the other hand, works in a different way.

What is Ozempic (semaglutide)?

Ozempic is an FDA-approved medication for type 2 diabetes in people with obesity who have serious weight-related health issues.

Ozempic has been shown to:

• Slow down digestion
• Controls hunger
• Regulate blood sugar levels
• Reduces food cravings

While Ozempic is authorized by the FDA to treat type 2 diabetes, its counterpart, Wegovy (also a semaglutide drug), is approved to treat excess weight gain.

How it works

Semaglutide, the main ingredient in Ozempic and Wegovy, mimics a hormone called GLP1 (glucagon-like peptide-1). This hormone is a workhorse that’s meant to regulate our appetite, digestion, and insulin release.

However, in people with obesity or insulin resistance, natural GLP-1 may not work as it should. Since Ozempic is a synthetic version of GLP-1, it is designed to produce similar effects.

Ozempic works to:

• Signal the brain's appetite center that you've had enough, which lowers your appetite
• Slow how food travels through your stomach so you can be satisfied with less food
• Reduce the risk of high blood sugar levels by triggering insulin release when you eat
• Suppress glucagon, a hormone that causes your liver to release glucose into your bloodstream, thereby preventing unwanted blood sugar spikes

The result? You could eat less without feeling constantly hungry, and your blood sugar stays more balanced.

Weight loss: berberine vs. Ozempic?

Berberine may have an impact on weight loss, but it cannot deliver Ozempic-level results.

Berberine weight loss

Research shows berberine could help you lose 4-5 pounds over 2-3 months. However, results may vary. One 2020 review found no significant weight loss with berberine, although they noted a slightly lower BMI and waist circumference.

Ozempic weight loss

Semaglutide medications, like Ozempic and Wegovy, produce more dramatic weight loss results:

• A landmark trial showed an average of 15% weight loss on over half of the people on semaglutide (some lost 20%!)
• The majority of people in the study on semaglutide lost at least 5% of their body weight
• A very small percentage did not lose weight on semaglutide

So, someone whose starting weight is 250 lbs may lose an average of 38 lbs, bringing their new weight to 212.5 lbs.

However, people with type 2 diabetes lost less weight on semaglutide (about 10 lbs in 7 months) versus those without diabetes.

Lower blood sugar levels: berberine vs. Ozempic

Berberine and blood sugar levels

Berberine does show promise for blood sugar management.

A 2024 review of 50 trials found that berberine, by itself, lowered fasting sugar and postprandial glucose levels (post-meal). Plus, together with diabetes drugs like metformin, berberine lowered HbA1c (a 3-month average of blood sugar).

A few small studies suggest that berberine may lower blood glucose levels similar to metformin in people with newly diagnosed or mild diabetes.

These effects are meaningful but modest compared to modern diabetes medications.

Note: Before taking berberine for diabetes, please consult with a healthcare provider.

Ozempic's effects on blood sugar

Studies show that Ozempic (semaglutide) lowered HbA1c levels by:

• 1.4 points in people on the 0.5 mg dose
• 1.6 points in those taking 1 mg

Overall, 70% of people taking Ozempic reached their target blood sugar levels during the course of the study, which is promising for people with diabetes.

In a 12-week study, people taking the 1 mg weekly Ozempic shot saw their morning blood sugar levels (fasting blood sugar) drop by about 29 points. So, for example, someone whose fasting blood sugar measured 150 before breakfast could see it fall to around 121.

How do you choose between berberine and Ozempic?

Berberine vs. Ozempic is not an apples-to-apples comparison, despite berberine sometimes being called "Nature's Ozempic." This distinction matters, especially if you have type 2 diabetes and obesity with weight-related health issues.

For these conditions, consult a healthcare provider about whether Ozempic, Wegovy or another GLP-1 medication might be appropriate alongside diet and exercise.

Who can take berberine?

Berberine is a dietary supplement found online, in pharmacies, and at stores like Costco—it’s available to everyone. However, it can interact with medications processed by the liver, including diabetes medications such as metformin.

If you take any medications, talk to your doctor before starting berberine for weight loss. It’s also not for people who are pregnant or breastfeeding.

The best choice may be one approved by your healthcare provider and ideally monitored under medical supervision.

Who can take Ozempic or Wegovy?

Ozempic is authorized by the FDA for people with type 2 diabetes to lower their blood sugar and reduce the risk of heart disease, stroke, and severe kidney disease. Clinically, obesity is defined as having a BMI of 30 or above).

Many health plans cover Ozempic only for what it’s indicated to do, which is treating type 2 diabetes.

Wegovy, on the other hand, 2.4 mg of semaglutide, is approved for weight loss to reduce weight-related complications like the risk of heart attacks and stroke. People who are obese or have excess weight that’s causing medical issues may also be eligible.

Both Ozempic and Wegovy are available by prescription only.

Safety and side effects

Berberine's side effects

Berberine is generally well-tolerated, with mild side effects at moderate doses. The most common issues are mild digestive discomfort like constipation or diarrhea at higher doses.

However, here are some things to consider before taking berberine:

• Studies only lasted 3-6 months, so long-term safety is unknown
• The research involved a small number of participants
• Most studies were conducted in Asian populations, whose body types differ from average Americans
• In the United States, the FDA does not regulate supplements. So, the quality and level of dosage may vary between brands
• Not recommended during pregnancy or breastfeeding
• The typical study dose is 500 mg taken with meals, 2-3 times a day

Note: While berberine shows potential, the evidence doesn't match the rigor required for FDA-approved medications like Ozempic. This doesn't mean berberine is ineffective—just that evidence isn't definitive yet, and we lack data on long-term effects, particularly on liver function.

If considering berberine, look for products that have undergone robust testing and received third-party quality certifications.

Ozempic's side effects

Ozempic has well-documented side effects, primarily affecting the digestive system:

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Constipation

Most side effects are mild to moderate and tend to improve over time. However, a small number of people in a clinical trial discontinued semaglutide due to adverse effects.

Drug interactions

Berberine can interact with medications by affecting liver enzymes that process drugs. It may increase blood levels of:

• Cyclosporine (used after organ transplants)
• Certain statins (cholesterol medications)
• Blood thinners like warfarin
• Some diabetes medications, including metformin

Always tell your doctor about any supplements you're taking to avoid dangerous interactions.

Ozempic drug interactions include:

• Enhance the effects of other medications that lower blood sugar, like insulin, potentially causing hypoglycemia
• Affects the absorption of oral medications because it delays stomach emptying
• Interact with certain antibiotics, antimalarials, warfarin and other anticoagulants, blood pressure medications, and more.

More benefits: Heart health

Berberine

Berberine has been shown to lower bad cholesterol (LDL) and triglycerides (fats circulating in your blood). Research also suggests it may help reduce inflammation in the body.

Additionally, since it improves insulin sensitivity, this might help reduce heart disease risk. While these changes aren't dramatic, they might contribute to better overall health.

Ozempic

Ozempic can reduce the risk of heart problems in people with type 2 diabetes. Some research shows that as people lose weight on Ozempic, they might see improvements in blood pressure and inflammation in the body.

What happens when you stop taking berberine or Ozempic?

An important consideration is what happens when treatment ends. There’s little data on what happens when people stop berberine, but since it’s side effects are more modest, any benefits could potentially diminis

There's little data on what happens when people stop berberine, but since its effects are more modest, any benefits could potentially diminish over time.

When people stop taking Ozempic/Wegovy, their appetite returns with a vengeance, leading them to regain their weight. One 2022 study found that patients who had lost about 17% of body weight on semaglutide regained two-thirds of that weight within just a year of stopping.

Diet and exercise are important

People who lost weight using semaglutide or berberine also improved their eating habits and stayed active. Semaglutide may make healthier food choices easier by reducing hunger and food-related thoughts.

While berberine hasn't been shown to directly reduce food cravings in humans, its ability to improve insulin sensitivity might help stabilize blood sugar levels, potentially preventing sudden carb cravings.

Regardless of whether you take berberine, Ozempic, or another solution, proper diet and physical activity remain essential for sustainable weight management.

A registered dietitian can develop a personalized nutrition plan based on your preferences and lifestyle to support your weight loss goals.

Final thoughts: Is Berberine “Nature’s Ozempic”?

Calling berberine "Nature's Ozempic" is more marketing than medical reality. While both can help with weight and blood sugar, they work differently. In fact, berberine works more like metformin.

Berberine offers modest weight loss benefits with fewer side effects and there’s no prescription needed. It might be worth considering if you have mild metabolic issues, want a complementary approach to lifestyle changes, or cannot access or tolerate Ozempic.

In any case, it’s best to consult a healthcare provider before taking berberine supplements.

Also, consider keeping your expectations realistic—you'll likely see small, gradual improvements rather than dramatic transformations.

Ozempic (semaglutide) delivers powerful results for weight loss and diabetes management but requires a doctor’s prescription, costs more, and may cause more side effects. It's typically recommended for people with obesity, established type 2 diabetes, or high risk of these conditions. Plus, studies show that once people stop semaglutide, they may regain a lot of the weight lost.

Weight loss is complicated, with or without prescription medication or supplements. To guide you through your weight loss journey, consider personalized support from a weight loss dietitian.

Frequently Asked Questions (FAQs)

1. How much berberine should I take for weight loss?

There is no standard prescribed dosage. Most studies used 1,000-1,500 mg per day, typically divided into 2-3 doses taken with meals. Start with a lower dose and gradually increase to minimize digestive discomfort. Always consult a healthcare provider before starting any supplement.

2. Is berberine safe for everyone?

Berberine is generally well-tolerated but isn't recommended during pregnancy or breastfeeding. People taking medications should consult their doctor because berberine can interact with many drugs. Those with liver or kidney disease should also use caution.

3. How long does it take to see results with berberine?

Most studies showed metabolic improvements within 4-12 weeks. Any weight loss effects tend to be gradual. Consistency is key to seeing benefits.

4. Can I take berberine and Ozempic together?

This combination hasn't been well-studied, and since both lower your blood sugar levels, there is a risk of hypoglycemia. Always consult your doctor before you take berberine for diabetes.

5. Is berberine FDA-approved?

No. Berberine is sold as a dietary supplement, not a medication. The FDA doesn't approve supplements for safety and efficacy before they reach the market, unlike prescription drugs like Ozempic.

6. Will my insurance cover berberine or Ozempic?

Insurance typically doesn't cover supplements like berberine. However, berberine is usually available at a much lower price than prescription drugs.

Ozempic may be covered by insurance for diabetes management, but coverage for weight loss (under the brand Wegovy) varies widely between plans. Check with your insurance provider for specific details.

Start losing weight now. Find a weight loss dietitian who accepts your insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.