Highlights

• Meta-analysis of 9 clinical trials
• Berberine significantly reduces BMI and waist circumference
• Typical dosage: 1,000 to 3,000 mg/day for 4 to 52 weeks
• Best results achieved with dosages above 1,000 mg/day for at least 12 weeks
• Low-dose dihydroberberine may be a more tolerable alternative

Summary

Study Design

One meta-analysis of 9 randomized, controlled clinical trials evaluating berberine on obesity parameters reported that, compared to control, berberine significantly reduced BMI by 0.3 kg/m² and waist circumference by more than 6 inches, with a trend toward weight loss.

Inclusion criteria included original trials published in the English-language, peer-reviewed literature that (1) involved adults with various health conditions; (2) compared intervention (berberine supplementation) to a control; and, (3) reported results with sufficient data on body mass index (BMI), waist circumference, and/or body weight for both groups.

Nine studies conducted between 2010 and 2018 were included in the analysis. One study reported results separately for men and women, yielding 10 data sets. Participants ranged from aged 26 to 65 years; interventions ranged from 4 to 52 weeks; and, berberine supplementation ranged from 1,000 to 3,000 mg/day. The studies were conducted in different countries, with the majority in China and others in Iran, Italy, and Mexico.

Outcome Measures

The primary outcome measures included changes in BMI, waist circumference, and weight. These outcomes were measured using weighted mean differences (WMD) with 95% confidence intervals (CI) for data pooling to evaluate the effect sizes.

Study Results

Results indicate berberine supplementation significantly reduced BMI and waist circumference, and showed a nonsignificant trend toward weight loss. Compared to controls, berberine supplementation resulted in the following changes:

• Decrease in BMI of about 0.3 kg/m²
  (WMD: −0.29 kg/m², 95% CI: −0.51 to −0.08, P=.006)
• Decrease in waist circumference of about 6.8 in.
  (WMD: −2.75 cm, 95% CI: −4.88 to −0.62, P=.01).
• Trend toward decrease in body weight of about 3 lbs
  (WMD: −0.11 kg, 95% CI: −0.99 to 0.76, P=.79).

Berberine was reported to be especially effective for women, individuals with obesity, and in studies with dosages above 1,000 mg/day and lasting more than 12 weeks.

Clinical Relevance

These results indicate berberine supplementation with a typical dosage of 1,000-3,000 mg/day for 4 to 52 weeks may offer therapeutic value for patients with obesity as part of a weight loss diet and lifestyle program. Best results are achieved with berberine dosages above 1,000 mg/day and lasting more than 12 weeks.

Note: A separate pharmacokinetic study in healthy men (Moon et al., 2021) indicates low-dose (100 or 200 mg) dihydroberberine (a highly bioavailable form of berberine) raises blood berberine levels more effectively than the high-dose berberine doses (500 mg) typically used for therapeutic effects. This suggests dihydroberberine may be a more tolerable and easier-to-follow treatment choice than berberine. A summary of this study is here.

References

Xiong P, Niu L, Talaei S, et al. The effect of berberine supplementation on obesity indices: a dose- response meta-analysis and systematic review of randomized controlled trials. Complement Ther Clin Pract. 2020;39:101113. https://pubmed.ncbi.nlm.nih.gov/32379652/

Moon JM, Ratliff KM, Hagele AM, Stecker RA, Mumford PW, Kerksick CM. Absorption kinetics of berberine and dihydroberberine and their impact on glycemia: a randomized, controlled, crossover pilot trial. Nutrients. 2021;14(1):124. Full study available free at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8746601/

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This information is for licensed healthcare professionals only to inform patient treatment. It is not intended for consumer use.