"Nature's Ozempic": slimming trend that went viral on Tiktok

When Savannah Crosby started posting videos on TikTok , little did she know her fate as a bad-influencer would come. Before going viral, she had about 500 followers, after a video about the use of Berberine, a food supplement for weight loss, Crosby now has more than 21,000.

“I take great joy and gratitude that sharing my experience has helped other women with the same struggles I have” trying to lose weight, said Crosby, a 34-year-old woman who lives in San Antonio and works for a real estate management company. 

The influencer's popularity is part of a larger trend. People dubbed 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 in helping people lose weight.

As Ozempic is expensive and can be difficult to obtain, it appears that some consumers have opted for berberine instead. On TikTok, videos about the supplement generated over 92 million views. But doctors and nutritionists caution that there is little evidence that berberine can actually help people lose weight and that the long-term effects of its use are unclear. In short, they say, berberine may just be the latest weight loss fad.

“People see a little capsule, something that 'they think' might help, and it really works, for a short period of time, but then it disappears,” said Deborah Cohen, a registered dietitian and associate professor in the Department of Clinical and Preventive Nutritional Sciences at Rutgers University.

Berberine comes from the root and bark of various plants and has been used in China as a medicinal herb since ancient times, according to a study in the journal Frontiers in Physiology. 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 came across an article about berberine while conducting research to determine whether insulin resistance could be why she was eating healthy but not losing weight.

“It signaled to me that there is something going on with my body,” Crosby said of the lack of results.

A report from the journal Clinical Nutrition Espen states that "obesity-induced inflammation can exacerbate insulin resistance" and that "berberine has anti-inflammatory effects."

Crosby said he would have asked the doctor for Ozempic but had given up on health insurance because of the cost. Even if she had coverage, many insurers wouldn't pay for the drug , which can cost upwards of $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, an associate professor at Harvard Medical School who studies supplements. There is significant evidence that Ozempic not only leads to weight loss, but also reduces the risk of health problems such as diabetes, heart disease or stroke, Cohen said.

A New England Journal Medicine study of semaglutide, the generic name for Ozempic, looked at nearly 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. These berberine trials typically last only one to three months, feature fewer than 70 participants, and typically don't 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 period of time. To know if there really are lasting effects, the studies need to be much, much longer,” said Deborah Cohen.

Even if the studies had a larger sample size and longer duration, people wouldn't necessarily be able to buy the same berberine used in the research because it's a supplement and not a pharmaceutical drug, Cohen said.

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 in products, and no one is verifying that the amount is accurately listed. on the label,” said Pieter Cohen.

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 tested in obese rats; although more studies are needed to assess berberine's impact 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, switched to berberine in October 2022 after gaining "about 30 pounds" in one year. She didn't want to take Ozempic because she had tried a different prescription weight loss medication that turned out not to be 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 drug, and potentially make it harder for people like her father, who has Type 2 diabetes, to get the drug. (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 212 pounds; 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 helped my confidence.

Despite these weight loss stories, doctors and nutritionists 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 berberine weight loss is safe, Cohen said. Crosby, the TikTok influencer, lost 3.5 pounds in eight weeks, she said. Her clothes fit differently and she has less of an appetite.

She received comments from people on social media who also saw the scales finally tipping. Others said they experienced headaches, bloating, and vomiting from the supplement. For anyone interested in berberine, Crosby advises people to talk to their doctor.

"Don't start picking things up just because they've become so popular," she said. “I wish berberine could help everyone, but obviously we have to be careful and remember that maybe not.”