Although traditional pharmacotherapy remains a key element in the treatment of high-weight and obesity-related comorbidities, many researchers have also investigated the effects of natural products in the management of heaviness. Due to their anti-obesity properties, these substances have been employed either as adjuncts to conventional drugs or in monotherapy.

One such example is the plant alkaloid berberine, which is considered an inexpensive and safe oral supplement commonly used as an over-the-counter (OTC) drug due to its myriad of effects on human health. Berberine is known to increase insulin sensitivity, lower blood glucose, reduce the risk of metabolic syndrome, improve lipid metabolism and stimulate weight loss. Previous reports have highlighted that berberine increases the mRNA expression of adiponectin, inhibits the differentiation of adipocytes, regulates glucose and lipid metabolism, and decreases the secretion of leptin and resistin.

Since hypercholesterolemia is a crucial issue, dietary supplements for the treatment of this dysfunction are widely studied and researched. Several products of natural origin have been reported as effective in lowering plasma cholesterol by acting with different mechanisms of action, and in recent years they have been frequently used as the main active ingredients of supplements available in pharmacies as over-the-counter medicines (OTC) or in regular markets without medical prescription. Among these, the most diffused on the market are [...] and berberine (BBR). These extracts/compounds are often used as the sole active ingredients of dietary supplements or are combined with each other in products also containing probiotics, coenzyme Q and vitamins.

Traditional herbs have gained more attention since they are often cheaper, more locally available, with fewer side effects than synthetic drugs. Berberine (BBR), a plant alkaloid with known pharmacological properties extracted from Chinese traditional herbs, has been the subject of more research about its ameliorative effect on CVD risk factors; through suggested mechanisms. The major risk factors for CVD are well-established and they include metabolic syndrome components (dyslipidemia, hypertension, diabetes or insulin resistance, and abdominal obesity), inflammatory markers, and liver enzymes. These risk factors contribute to future CVD, stroke, diabetes, and mortality in individuals. BBR supplementation could be effective in either primary prevention or secondary prevention of CVD. Preclinical (animal, in vitro) studies demonstrate that BBR has positive effects on lowering blood lipids, blood glucose, and controlling weight and blood pressure.