The effect of berberine on obesity indices: a systematic review and meta-analysis.

BACKGROUND AND AIM: Obesity is an already identified risk factor for various noncommunicable diseases. Berberine is an alkaloid that has manifested a significant effect in the treatment of obesity and its complications. The aim of this systematic review and meta analysis is to evaluate the effect of berberine on obesity indices.

METHODS

We conducted a comprehensive search of Scopus, PubMed, Web of Science, and Google Scholar for randomized controlled trials (RCTs) investigating berberine's impact on obesity indices in adults. Eligible studies included human trials with quantitative outcomes for weight, BMI, WC, or WHR. Animal studies, reviews, and non-RCTs were excluded. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. A random-effects meta-analysis was performed to calculate mean differences (MDs) and 95% confidence intervals (CIs). Heterogeneity was evaluated using I² statistics.

RESULTS

A total of 23 articles were included. Berberine significantly reduced body weight (MD of -0.88 kg, 95% CI: -1.36 to -0.39, p = 0.0003), BMI (MD of -0.48 kg/m², 95% CI: -0.89 to -0.07, p < 0.0216), and WC (MD of -1.32 kg/m², 95% CI: -2.24 to -0.41, p < 0.0046). However, berberine did not significantly reduce WHR compared to control groups (MD of -0.01, 95% CI: -0.03 to 0.01). Meta-regression revealed no association between berberine use and age.

CONCLUSION

Berberine use significantly reduces body weight, BMI, and WC but does not significantly reduce WHR. Future trials should focus on improving reporting standards for biochemical characterization (such as purity, potency and gram amounts) and address common biases such as lack of blinding and randomization to enhance the reliability of the evidence.