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For the first two weeks, Megan Waelz had a pretty positive experience taking berberine — the supplement many on social media are calling “nature’s Ozempic.”
“I think everyone is seeing all of the content around all of the various shots you can take to lose weight,” Waelz, 29, said, referencing the semaglutide injection drugs Ozempic and Wegovy, both of which have exploded in popularity in the last few years.
Ozempic is designed to treat type 2 diabetes, while Wegovy is a weight loss drug prescribed to people with certain health conditions. They are both among a class of drugs that have recently been widely used for weight loss, even in the absence of the conditions the drugs are designed to treat. The explosion in off-label semaglutide use has resulted in a shortage of the drug. Celebrities have spoken openly about using Ozempic, and many on social media are posting about new prescriptions and the side effects. According to the New Yorker, Novo Nordisk, the company that manufactures Ozempic and Wegovy, reported international market growth of 50% in a 2022 year end earnings call, claiming nearly 40,000 new Wegovy prescriptions written each week. But, Ozempic and Wegovy can be costly — more than $1,000 a month without insurance.
For Waelz, a cheaper and prescription-free alternative was attractive. “I had seen a ton of content about berberine and not too much about side effects, aside from the common ones you see on pretty much any vitamin,” she said. “I found one on Amazon that was pretty highly rated. It came within a couple days and I was immediately taking it.”
Waelz didn’t really notice any big improvements in those first two weeks, but she wasn’t having any negative reactions, either — until things went really, really bad.
“I went to take it one morning — the pills are massive — and I kind of choked a little bit. They taste absolutely awful, so I drank a ton of water,” Waelz told Teen Vogue. “I don’t know what my body did, it was just fully rejecting this supplement. I immediately vomited everything out of my system.”
For two full days, Waelz says she was vomiting and had diarrhea, unable to keep food down. She stopped taking berberine upon having this reaction, and never considered starting again.
As more and more people open up about using Ozempic and the drug becomes increasingly easy to access for weight loss use through digital health companies, experts say many are turning to berberine because it’s cheaper, doesn’t require a prescription, and promises a “natural” alternative to a pharmaceutical. The supplement’s efficacy is questionable, but beyond the physical impact, some say one of the biggest dangers of the spike in interest in berberine might be the obsession with diet culture that’s likely driving it.
What Is Berberine?
According to MedlinePlus, a service of the U.S. National Library of Medicine, berberine is a chemical found in various plants, like European barberry and goldenseal. It’s most often used to help control diabetes, high cholesterol, and high blood pressure, but MedlinePlus notes that there’s no good evidence to support its efficacy. Still, berberine has gained popularity on social media over the last few months for its supposed weight loss qualities — hence its nickname as nature’s ozempic. Given the shortage, the high price of semaglutide injections, and the need for a prescription, some may be turning to readily available supplements to achieve the same effect.
According to Wajahat Mehal, MD, DPhil, professor of medicine (Digestive Diseases), director of the Yale Weight Loss Program, and director of the Yale Fatty Liver Disease Program, there is no such thing as “nature’s ozempic.”
“[Calling berberine nature’s ozempic is] suggesting that this item has the same qualities the other product has, or has some other similarity,” Mehal said. “There really aren’t any similarities.”
Besides the differences in their makeup, Mehal said that Ozempic is a drug that’s manufactured by one company, with heavy oversight from the federal Food and Drug Administration. The efficacy of supplements isn’t regulated by the FDA, and there are insufficient regulations around their safety or the claims they can make about their impact. Largely, supplement companies are responsible for their own quality and safety testing. And, berberine hasn’t really been proven to provide the results many claim it will.
Dr. Mehal said there have been a few studies on berberine’s impact on weight, though the majority have been in animals — namely mice.
“There are animal experiments that suggest it has moderate impact on weight and inflammation. What there isn’t is human data,” he said. “So many drugs that have been in development have shown encouraging data at the animal stage, but when you do the human study you find it has no effect. So it’s not to say there’s zero data, but based on animal data we cannot recommend [berberine].”
Berberine itself may not be physically harmful, but Amanda Raffoul, PhD, MSc, an instructor in pediatrics at Harvard Medical School and faculty member of the Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED) at the college’s School of Public Health, told Teen Vogue that the lack of safety testing on supplements in general could pose health risks.
“With any sort of dietary supplement, the thing that’s most important to consider is that these are not regulated like drugs. The FDA doesn't test these products for efficacy, they’re not screened for safety in advance,” Dr. Raffoul told Teen Vogue. “Because of those two pieces, supplements in general, especially those marketed for weight loss, there are a lot of health risks.”
According to MedlinePlus, berberine can include side effects like diarrhea, constipation, gas, and upset stomach. While it notes that the supplement is “possibly safe” for most adults for short term use, Dr. Raffoul said it’s impossible to know what else may be in the supplement you’re taking. Aftermarket FDA testing of other supplements — those marketed for weight loss specifically — has found potentially dangerous ingredients.
Still, countless TikTok posts extoll the virtues of the supplement — even in cases where it has caused gastrointestinal side effects. Dr. Raffoul suspects the spike in interest belies a bigger issue.
“Thin Is In”
Behind berberine’s popularity, Dr. Raffoul said, is diet culture.
“I think there’s such a pressure in our culture to have a thin body and to lose weight and to look a certain way that people will go to really extensive costs and do a lot to try and manage their body weight, even if it’s harming their overall health,” Dr. Raffoul said.
As berberine’s nickname hints at, its popularity may also be linked to the increase in Ozempic use.
“Right now, [Ozempic is being called] this miraculous weight loss drug. That type of conversation masks the health risks of taking a product like Ozempic, and it reinforces this cultural narrative that you have to be thin and doing anything you can [to get there],” Dr. Raffoul continued. “For young people who are not taking Ozempic … they might see their favorite celebrities talking openly [about using it] and think, ‘well, I’m going to try and find ways to achieve that body as well.’ That dialogue contributes to things like berberine being really popular.”
This was the case for Waelz, who grew up seeing skinny models in magazines and watching weight loss commercials on television. Because many diet pills in the past were found to be dangerous, Waelz said Ozempic — which studies have so far found largely to be safe for their prescribed use — is alluring, but out of reach.
“[Ozempic] is so easy and finally we don’t have to feel like we have to diet like crazy and work out like crazy. [People] were doing really dangerous things [to lose weight], it feels like, ‘ok I could get that thing without all the additional harm,’” she said. But, Ozempic is expensive, and Waelz said there’s an ethical issue, given that the drug is used to treat type 2 diabetes, and the shortage has prevented some people with diabetes from getting the medication. That’s where berberine comes in. “There’s an alternative for 20 bucks on Amazon? I’ll give this a try.”
And, in a culture that has historically prioritized thinness, who could blame that logic?
In a 2022 essay for The Cut, Michelle Santiago Cortés documented the return of “thin culture,” noting how the body positivity movement of the 2010s seemed to be reverting back to the relentless obsession with thinness that marked the ‘90s and ‘00s. Santiago Cortés notes that our collective obsession with thinness never really went away, and it should be noted that anti-fat bias is inherently tied to racism and white, European beauty standards. But, we saw small steps in the right direction over the last few years: runways became somewhat more inclusive, magazine covers more diverse, and the standards we held one another to seemed to ease up. Now, however, extreme thinness and the pursuit of it seem to be on the rise.
Waelz said she’s noticed this change, and it speaks to a deep-seated and troubling reality that diet culture makes it difficult to escape. “No matter how much body positivity we have and how confident we want to feel,” she said, “there’s a part of us that’s not happy with how our body looks.”
This is the problem: No matter the cultural moment, anti-fat bias still exists and it’s ingrained in many of our minds, even if we want to be free from it. Weight loss medication, for some, is a helpful and necessary tool in improving their health, both physically and mentally. But the popularity of largely unregulated weight loss supplements that may or may not work, and may or may not give you aggressive diarrhea, is a reflection of just how difficult it is to care compassionately for our bodies regardless of size. We all live in the same environment where thinness is prioritized.
Writing for Self magazine about how body trends most impact people of color, Virgie Tovar, author and advocate against weight based discrimination, summed up the inescapability of our own subscription to diet culture:
“When body size is viewed as a referendum on beauty, we lose sight of this complex, harrowing reality; when we’re told that a body size is a trend, we naturally react to that information by competing — to take ‘in’ or ‘out’ sides,” Tovar wrote. “This dooms us to the cycle of body dissatisfaction that keeps us trapped in diet culture and, more urgently, shifts our focus away from creating a world where it’s safe for everyone to have the body they have.”
There’s No Magic Pill
Savannah Crosby, who started taking berberine around April, has had a pretty good experience with the supplement. She said she hasn’t felt any alarming side effects, and she felt like it achieved at least some of what she hoped it might — though not the dramatic results others seemingly promise. Crosby, 34, started taking berberine because she was interested in using a semaglutide for weight loss, but didn’t have a prescription and couldn’t afford the steep costs. She saw claims that berberine could lead to weight loss, and the $20-ish price tag was much more affordable. After taking berberine for three months, Crosby took a break from it (as she had planned to from the outset) and reflected on her experience on TikTok.
“Unfortunately, there’s no magic pill out there,” she said in a video posted on July 11. In the video, Crosby seems sort of discouraged.
“I have been searching for that thing that’s going to help me maintain or lose weight. In the society we’re in, growing up and seeing the commercials for SlimFast, on social media [seeing weight loss content]…we want to find that thing that works, that you’re going to take it and it’s going to be easy and it’s going to stay off and all your problems will be solved,” she told Teen Vogue in an interview. She has since started taking berberine again. “That isn’t the case.”
At first, Crosby thought maybe berberine would be that magic bullet — even if she technically knows such a thing doesn’t exist. This dichotomy is a unique trap of diet culture that so many of us fall into, even those of us who seem most averse to it.
In an essay for Vogue, Emma Specter wrote about Ozempic and the allure of weight loss medication after years of unlearning diet culture and fatphobia.
“I’ve spent years coming to terms with my own identity as a fat person and trying to internalize the idea that nobody gets to have an opinion on my body — nor should I have an opinion on anyone else’s,” they wrote. “Still, when I see celebrities like Amy Schumer — whose weight has been as obsessively discussed as anything else in her life or career, whether she liked it or not — speak openly about using Ozempic, the fatphobic part of my brain I thought I’d excised long ago panics and whispers: Should I be doing it too?”
Marianna Moore, who has her Masters of Science in nutrition and is a certified strength and conditioning specialist, challenges the idea of these so-called magic supplements on TikTok. She called out berberine specifically in an exasperated video, asking viewers to be “so astronomically f*cking for real” about yet another quick fix weight loss claim. In an interview with Teen Vogue, Moore stressed that there is no magic pill for weight loss, but there are a lot of untested supplements that claim to be.
“When you get these ‘magical’ supplements coming out that get all this attention….and they’re attached to these very bold health claims, that’s when it’s like, ‘ok, where is this coming from?’” she said. “If it sounds too good to be true, it probably is.”
These kinds of supplements — from berberine to green powders — are the most current iteration of the diet industry, Moore said.
“This is the power of marketing. If you attach the name ‘nature’s Ozempic,’ something not everyone can get their hands on but people want…people are going to try it. The diet industry has been doing that for decades now, but more so selling diets,” Moore said, saying that supplements are just the newest and quickest version of selling diet plans. Social media, she said, has turbo boosted the diet industry, making it seem much more relatable — and attainable — when we see influencers we like engaging in it. “It’s relatable and gives people hope.”
Moore said the desire for thinness is driving the current berberine popularity, and is behind the litany of fad diets, pills, and other weight loss trends of the past. That desire for thinness may also be linked to the idea that being thin is synonymous with being happy, particularly among young people.
Research published in the journal BMC Public Health found that “by consuming dietary supplements and wearing tight-fitting branded sportswear, influencers promise a simplified way of optimizing one’s appearance as the key to happiness.” In looking at the role influencers play in communicating health messaging to young people in Germany, researchers found that much of that messaging was playing into the idea that thinness is the key to wellbeing and happiness, and that thinness can only be achieved via their suggestions, which often includes selling products.
“Building a connection between external beauty and perceived well-being, and thus mental health, is a direct effect of influencers’ health communication,” the study reads. “Messages imply that an ideal body image cannot be achieved without following the given advice, which predominantly pushes the consumption of presented goods. An alleged dependence on happiness, contentment and beauty is suggested: Only those who are beautiful can achieve happiness.”
For Crosby, hearing about some of the adverse reactions to berberine has underscored the lengths people will go to achieve thinness. People would direct message her about having chronic headaches or gastrointestinal issues while taking berberine, but when she suggested they might want to stop taking it, some didn’t.
“I think people continue to take it [despite negative reactions] because it’s like, well if it’s going to make me lose weight, I don’t care,” she speculated.
It’s been about two months since Waelz stopped taking berberine, and she has no plans to start up again given the reaction she had. She wishes our culture wasn’t so obsessed with thinness, and is skeptical about the proliferation of weight loss drugs and the impact the conversation about them might have on young people.
But, if she knew berberine wouldn’t make her sick, would she take it again?
“Probably.”
