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  • Systematic Review
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Clinical Research

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

International Journal of Obesity volume 50, pages 53–73 (2026)Cite this article

Subjects

Abstract

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.

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Data availability

Data of this study are available upon a reasonable request from the corresponding author.

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Author information

Author notes

  1. These authors contributed equally: Iman Elahi Vahed, Erfan Shahir-Roudi, Sina Nojumi.

Authors and Affiliations

  1. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Iman Elahi Vahed & Amir Sajad Bagheryan

  2. Student Research Committee, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran

    Erfan Shahir-Roudi

  3. School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Sina Nojumi & Niloofar Sharafi Tafreshi Moghadam

  4. School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Samieh Golmohammadi

  5. School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Mehdi Moradi Shahrebabak

  6. School of Medicine, Jundishapur University of Medical Sciences, Ahwaz, Iran

    Maryam Moftakhar

  7. Student Research Committee, School of Health, Guilan University of Medical Sciences, Rasht, Iran, Rasht, Iran

    Fateme Shamsipour

  8. School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

    Mahla Jafari

  9. Department of Stem Cells Technology and Tissue Regeneration, Faculty of Interdisciplinary Science and Technologies, Tarbiat Modares University, Tehran, Iran

    Hossein Soltaninejad

  10. Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohammad Rahmanian

  11. Student Research Committee, School of Medical Education and Learning Technologies, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohammad Rahmanian

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Contributions

Conceptualization: MR; Methodology: IE; Validation: MR, MM, MJ, AB, MMS, and HS; Investigation: SN, FS, MMS, MR, and ES; Formal analysis: IE; Data curation: IE, MR, NS, MM, SG, and SN; Writing—original draft preparation: ES, SN, and SG; Writing—review and editing: MR, HS, MMS, SN, NS, AB, MM, IE, FS, and MJ; Supervision: MR; Project administration: MR and HS; All authors have read and agreed to the published version of the manuscript.

Corresponding authors

Correspondence to Hossein Soltaninejad or Mohammad Rahmanian.

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Elahi Vahed, I., Shahir-Roudi, E., Nojumi, S. et al. The effect of berberine on obesity indices: a systematic review and meta-analysis. Int J Obes 50, 53–73 (2026). https://doi.org/10.1038/s41366-025-01943-x

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