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Evidence based
Evidence Based

This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.

Does “Nature’s Ozempic” Live Up to the Hype?

Written by Michael Ruscio on May 30, 2024

Choosing Foundational Strategies Over Berberine May Be Better for Weight Loss

Ozempic has been making news headlines for its blood sugar benefits and potential to induce weight loss. But without insurance coverage, it’s expensive and the supply hasn’t kept up with the demand making it difficult to get. Enter berberine—a common dietary supplement that’s now being advertised on social media as “nature’s Ozempic.” 

In this article, I will explain what Ozempic is and how it works. I’ll also share important details about berberine, why it’s gotten the “nature’s Ozempic” title, and whether science supports this distinction.

Ozempic has been making news headlines for its blood sugar benefits and potential to induce weight loss. But without insurance coverage, it’s expensive and the supply hasn’t kept up with the demand making it difficult to get. Enter berberine—a common dietary supplement that’s now being advertised on social media as “nature’s Ozempic.” 

In this article, I will explain what Ozempic is and how it works. I’ll also share important details about berberine, why it’s gotten the “nature’s Ozempic” title, and whether science supports this distinction.

What is Ozempic?

Ozempic is the brand name of a Food and Drug Administration (FDA) approved injectable drug called semaglutide (a glucagon-like peptide-1 receptor agonist or GLP-1RA). It’s most often prescribed (along with diet and exercise) to help adults with type 2 diabetes control their blood sugar. When blood sugar levels are well-controlled, the risk of serious complications like heart disease, blindness, neuropathy, and kidney disease can be significantly reduced [1]. 

How Does Ozempic Work?

To better appreciate the usefulness of Ozempic for people with type 2 diabetes, let me share a brief review of how the body manages blood sugar. 

When you eat a meal, especially one that contains carbohydrates, your pancreas produces a hormone called insulin. Insulin acts as a shuttle to get the glucose (sugar) from the meal out of your bloodstream and into the cells of your body so it can be used for energy. 

People with type 2 diabetes either don’t produce enough insulin or they can’t use their insulin properly (insulin resistance), so blood sugar levels remain elevated. If this continues day after day, the risk of type 2 diabetes complications increases significantly. This is where semaglutide drugs (like Ozempic) come in handy—they reduce blood sugar levels, which tends to mean better health and less risk of serious health complications. 

Specifically, semaglutide activates GLP-1 receptors in the pancreas and brain to make insulin production more efficient—appropriate amounts of insulin equate to better blood sugar control [1]. In addition to more efficient insulin production, semaglutide drugs [2]:

  • Stop the release of glucagon (a pancreatic hormone that increases blood sugar)
  • Reduce the liver’s production of sugar, both when fasting and after meals
  • Improve insulin sensitivity

I want to point out here that Ozempic is not a cure for type 2 diabetes and it’s not used to treat type 1 diabetes or diabetic ketoacidosis [1]. 

Though it’s not specifically designed for weight loss, Ozempic is being used off-label as a weight loss drug for people with or without type 2 diabetes [1]. Let’s shift from blood sugar management to how Ozempic may exert its weight loss benefits.  

Ozempic for Weight Loss

You’ve likely heard of people who have lost an enormous amount of weight on Ozempic. But research suggests it may not be all that effective when it comes to healthy weight loss.

A 2024 meta-analysis of 76 randomized controlled trials studying semaglutide drugs in patients with type 2 diabetes found that 6–12 months on the drugs led to an average loss of 7.2 pounds of body weight. Weight loss went down to 6 pounds when the drugs were used for over a year [3].

Nevertheless, some people lose a significant amount of weight on Ozempic, so what gives? It’s not entirely clear, but the drug may slow the movement of food through the stomach reducing appetite and thus substantially lowering calorie intake [1]. Fewer calories taken in over time tends to lead to weight loss. 

Outside of calorie reduction, weight loss on Ozempic may be the result of gastrointestinal side effects like nausea, vomiting, diarrhea, and constipation [4]. If you experience GI upset every time you eat, you’re probably going to skip many a meal. One 2021 literature review concluded that GI side effects may be partly responsible for weight loss in some people on semaglutide drugs [5]. 

With that background out of the way, let me get into what berberine is and why it’s being called “nature’s Ozempic.”

What is Berberine?

Berberine is an alkaloid compound found in many different plants like Oregon grape, barberry, and goldenseal [6]. It may seem like the new kid on the block but berberine has been used for more than 3,000 years—first in traditional Chinese medicine (TCM) and more recently in the integrative and functional medicine space [6]. 

Medicinally, berberine acts to lower inflammation and fight oxidation, and it has antimicrobial properties [6, 7]. Traditionally, it’s been used for fever, wound healing, toothaches, inflammation, and digestive symptoms [6, 7. Animal studies suggest berberine may exert gut health benefits by improving leaky gut and dysbiosis [8, 9] and targeting motility [10]. One 2015 randomized controlled trial in IBS patients showed 800 milligrams of berberine HCl for 2 months improved diarrhea frequency, abdominal pain, urgency, anxiety, and depression [11].

More recently, berberine herbal supplements have become a popular option for improving blood sugar—thus its new designation as “nature’s Ozempic.”  Let’s take a closer look at how berberine improves blood sugar, and then see how it compares to Ozempic when it comes to weight management. 

Berberine for Blood Sugar Regulation

The blood sugar-lowering benefits of berberine have been known for quite some time [12]. They seem to be a result of improved insulin sensitivity and glucose uptake into the cells through the activation of enzymes that regulate energy use (SIRT1 and AMPK) [13, 14]. But berberine also helps to reduce inflammatory markers like IL-6, TNF-α, and CRP. This reduction in inflammation may partly explain why berberine helps to reduce hemoglobin A1c (a marker of average blood sugar control over 2–3 months) [15].

While we don’t yet have data comparing berberine to Ozempic, a 2021 meta-analysis of 46 randomized controlled trials showed berberine lowered blood sugar levels to a similar degree as metformin (the most established type 2 diabetes drug). When metformin and berberine were combined, these benefits were amplified [14]. 

The data for using berberine to lower blood sugar is strong. As I mentioned in the intro, Ozempic may be expensive (about $900 a month without insurance coverage) and difficult to come by due to drug shortages. Berberine is far less expensive (about $20–$50 a month) and is pretty easy to get over the counter. For those with elevated blood sugar, it may be worth it to discuss berberine with a healthcare provider as a natural option for keeping blood sugar in check (along with diet and lifestyle).

Here’s a table comparing important details about berberine and Ozempic:

OutcomeBerberineOzempic
Controls blood sugar Yes [14]Yes [1]
Induces weight lossNo [16]Yes [1]
Reduces inflammationYes [14, 15, 17]Yes [18]
Improves gut healthYes [11, 19]No (5)
Side effectsFewer [14, 20, 21] More [1, 3, 4, 22]
Cost without insurance$20–50/month$900+/month

It’s important to know that as with all dietary supplements, not all of the berberine options out there are created equally. A recent report from ConsumerLab.com showed that many of the 33 berberine supplements they tested from Walmart and Amazon contained less than half of the berberine stated on the label. It’s best to look for supplements with GMP certification, third-party testing, and allergen information.

Here’s how we typically dose berberine in the clinic: 

  • Dose: 770–2,400 mg/day in divided doses with food to reduce the risk of GI symptoms like constipation, diarrhea, flatulence, and abdominal pain [20, 21]
  • Duration: Proven safe for 6–12 months 
  • Form: Berberine HCl 

Remember, it’s always best to discuss any dietary supplement with your healthcare provider first.

When it comes to blood sugar control, berberine may live up to the “nature’s Ozempic” title. But you likely saw in the above table that berberine isn’t a great weight loss supplement—let me share the research.

Berberine for Weight Loss

If you’re thinking of trying berberine to support you in your weight loss journey, you may be disappointed. 

Despite being touted on social media platforms (like TikTok and Instagram) as an alternative to Ozempic for weight loss effects, berberine doesn’t appear to be a great option. A recent umbrella review of meta-analyses showed an average weight loss of just 1.9 pounds in 17,256 participants [21]. 

Hypothetically, any weight loss benefits of berberine may be due to increased fat burning and improved metabolism [13, 23].

If you’ve been planning on trying berberine, I don’t want you to feel disheartened. We have many natural options for helping you lose weight if that’s your goal. 

Creating a Foundation for a Weight Loss

It can be really frustrating to feel like you’re doing all the right things with your diet and exercise but still aren’t reaching your weight loss goals. I like to use a recipe analogy here—in order to make a great dish, you not only need all the right ingredients, but you also have to layer them in the correct order. In my experience in the clinic, many of my clients have the ingredients for weight loss, they just need some guidance on how to apply them.  

The recipe for weight loss success will be different for everyone. But building a healthy foundation with research-backed natural strategies (that are applied consistently) can help create an environment in your body that makes it easier to reach your weight loss goals. So let’s get into what it looks like to create a healthy foundation for weight loss.  

Diet for Weight Loss

Without question, diet has a huge impact on health and weight. In the clinic, we harness the power of nutrition to improve gut health, mood, energy levels, blood sugar, weight, and much more. 

I would love to tell you there’s one specific diet for weight loss but that’s just not the case. We’re all different and require a personalized approach. But generally, research suggests a whole-foods meal pattern high in protein (about 15–25% of calories) and low in processed foods may be effective for weight loss [24, 25, 26, 27, 28, 29, 30]. 

But what types of diets fit this description? Here are three science-backed dietary patterns that when combined with regular exercise can induce significant weight loss:

Along with what you’re eating, the size and timing of your meals may impact your ability to lose weight. Years ago, I remember being told to eat small, frequent meals throughout the aday. But research has suggested this type of eating pattern may actually contribute to weight gain (especially fat around the belly and in the liver) [29]. 

It may be best to eat fewer, larger meals, which tends to increase the calories you burn during digestion [24]. And if it feels good to you, intermittent fasting may give you a weight loss edge—as well as improve metabolic parameters like insulin sensitivity and triglycerides [37, 38, 39, 40, 41, 42, 43, 44, 45].

Exercise for Weight Loss 

As with diet, there isn’t a one-size-fits-all approach to exercise. For my clients in the clinic who are new to exercise, I recommend building a solid base by walking as much and as often as possible, preferably outside in nature. 

Once a foundation of walking is established, I encourage at least two days of full-body resistance training each week and here’s why—as we age, it’s important to maintain muscle mass for both metabolic health and to maintain our functional ability. My podcast guest, Dr. Gabrielle Lyon (a muscle-centric practitioner) refers to muscle as the organ of longevity and she’s spot on. 

During our discussion, Dr. Lyon discussed the two factors that contribute to muscle protein synthesis—dietary protein (thus the recommendation for a higher protein diet) and resistance training [46]. 

Recent evidence suggests that resistance training, typically 3 days per week, can raise the metabolic rate and thus the number of calories burned each day [47].

In addition to walking and resistance training, sprinkling in other forms of exercise like swimming, hiking, jogging, and cycling can help improve overall health and cardiorespiratory fitness.

Lifestyle for Weight Loss

Getting diet and exercise habits established can go a long way when it comes to losing weight. But you can easily sabotage your results if you neglect other lifestyle factors like sleep, stress, and community. The following table highlights tips for success in each of these important categories: 

Lifestyle Strategy Tips for Success
Restful Sleep
  • Set a bedtime routine and a consistent bedtime and waking time [48]
  • Avoid all-nighters and shift work if possible [49]
  • Try to eat dinner at least two hours before bedtime
  • Avoid bright lights and screen use for at least two hours before bed [50]
  • Modify the bedroom environment (temperature, lights, sounds) to support good sleep [51]
  • Address breathing problems, like mouth breathing, snoring, sleep apnea, or allergies, by consulting with a medical professional [52, 53, 54]
  • Exercise regularly, but avoid vigorous exercise close to bedtime [55]
  • Try taking melatonin to help you fall asleep quickly, and try probiotics for general sleep support [56, 57, 58, 59, 60, 61, 62]
Stress Management
Community
  • Create and nurture healthy relationships [67, 68, 69, 70]
  • Get involved with people who have common interests
  • Learn a new activity with family or friends [71, 72]
  • Volunteer at a local food bank or pet shelter [73, 74, 75]
  • Join a hiking or walking group [76, 77]

As you can see, there are a lot of options here but don’t feel overwhelmed. In the clinic, we suggest our clients take one or two suggestions from each category and start applying them consistently. As they get their healthy lifestyle established, we encourage them to add new challenges and goals over time. 

Other Supportive Therapies for Weight Loss

Creating a healthy foundation with diet, exercise, healthy sleep, stress management, and community is a top priority for improving health and weight loss if that’s your goal. There are a couple of other supportive therapies to consider once the foundation is in place:

  • Red light therapy doesn’t necessarily help with weight loss but it may help reduce body fat and improve body composition (less fat and more muscle) [78, 79, 80].
  • Cold exposure may increase metabolism both at rest and after exercise [81, 82, 83].

A Healthy Foundation Outperforms “Nature’s Ozempic” for Weight Loss

Berberine is being touted as a “nature’s Ozempic” for blood sugar control and weight loss. Research has established the benefits of both Ozempic and berberine for improving blood sugar. But the data for using berberine as a weight loss tool isn’t there. 

If you feel like you’re doing all the right things to lose weight but are coming up empty-handed, medications and supplements can be really enticing. I’m not anti-medication or anti-supplement by any means but there are many research-backed natural strategies to help with weight loss if that’s your goal. 

My clients in the clinic tend to do well when they establish a healthy foundation with a higher protein diet, resistance training, healthy sleep habits, daily stress management techniques, and developing a supportive community. If you lay this foundation but still aren’t reaching your goals, we’d love to support you on your journey. Contact us at the Ruscio Institute for Functional Health for an appointment.

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

Dr. Michael Ruscio is a DC, Naturopathic Practitioner, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

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