Both Ozempic and Berberine have received a lot of air time in recent months regarding their effects on weight loss. While they can both influence weight loss in the appropriate individual, their mechanisms of action, side effects, and efficacy differ. In the following sections, we outline the distinctions between the two options, delve into their historical usage, and explore the evidence.

1. Mechanism of Action:

- Berberine works by activating the AMPK enzyme - our master metabolism switch, which improves insulin sensitivity and glucose metabolism.

- Ozempic and other semaglutide drugs belong to a class of medications called GLP-1 receptor agonists. They work by mimicking GLP-1, a hormone that stimulates insulin release, reduces glucagon (a hormone that cues the liver to produce glucose) secretion, slows gastric emptying, and promotes a feeling of fullness.

2. Usage and Approval:

- Berberine: Berberine is a natural compound derived from certain plants and has been used traditionally in Ayurvedic and Chinese medicine for thousands of years. Berberine is a natural alkaloid found in various plants, including goldenseal, barberry, and Chinese goldthread. In Ayurvedic medicine, berberine-containing plants have been used for their antimicrobial, anti-inflammatory, and digestive properties. Traditional Chinese medicine has also employed berberine primarily for its beneficial effects on the gastrointestinal system, including treating diarrhea and dysentery.

- Ozempic is a brand name for semaglutide, an injectable medication approved by the FDA for treating type 2 diabetes. Other semaglutide drugs, such as Rybelsus and Wegovy, are also approved for various indications of type 2 diabetes and weight management.

3. Clinical Evidence:

- Numerous studies have investigated the effects of berberine on blood sugar regulation. Clinical trials have shown its effectiveness in lowering fasting blood glucose levels, reducing HbA1c levels, and improving insulin sensitivity in individuals with type 2 diabetes and prediabetes.

- Clinical trials have demonstrated the efficacy of semaglutide drugs in lowering blood sugar levels, reducing HbA1c levels, and promoting weight loss in individuals with type 2 diabetes.

4. Side Effects and Safety:

- Berberine: Berberine is generally considered safe when used appropriately, but due to its antimicrobial/antifungal properties, it can cause gastrointestinal side effects in some individuals, such as diarrhea, constipation, or stomach upset. It may also interact with certain medications, so consulting a practitioner is advised, particularly for individuals with underlying health conditions.

- Ozempic and other semaglutide drugs may cause side effects such as nausea, vomiting, diarrhea, or constipation. In some cases, they can lead to pancreatitis or kidney problems. They may also have implications for thyroid function and should be used with caution in individuals with a history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. In addition, they contribute to muscle loss along with fat loss unless lifestyle changes, like strength training and protein intake, are added along with medication usage.

As a holistic healthcare practitioner, I have used Berberine for a long time in my practice as an excellent tool to help regulate blood sugar in addition to real diet and lifestyle changes. If blood sugar dysregulation is at the heart of an individual’s weight issues, it can be really helpful. However, I do NOT recommend berberine or any drug as a stand-alone intervention for weight loss ever. If it is effective in the short-term, without real lifestyle change to accompany, the benefits gained will be temporary and fleeting.

References:

1. Yin, J., Xing, H., & Ye, J. (2008). Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism, 57(5), 712-717.

2. Pratley, R. E., Aroda, V. R., Lingvay, I., Lüdemann, J., Andreassen, C., Navarria, A., ... Rana, A. (2019). Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. The Lancet Diabetes & Endocrinology, 7(7), 493-505.

3. Nauck, M. A., Stewart, M. W., Perkins, C., Jones-Leone, A., Yang, F., Perry, C., & Reinhardt, R. R. (2020). Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1-3 oral antidiabetic drugs (LIRA-WD): a randomised, double-blind, phase 3b trial. The Lancet Diabetes & Endocrinology, 8(7), 576-586.

4. Dong, H., Wang, N., Zhao, L., Lu, F., & Xu, L. (2012). Berberine in the treatment of type 2 diabetes mellitus: A systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2012, 591654.

5. Rybelsus [Prescribing Information]. (2021). Novo Nordisk A/S.

6. Zhang, Y., Li, X., Zou, D., Liu, W., Yang, J., Zhu, N., ... Zhang, H. (2008). Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. The Journal of Clinical Endocrinology & Metabolism, 93(7), 2559-2565.

7. Wegovy [Prescribing Information]. (2021). Novo Nordisk A/S.