Berberine and Adiposity in Diabetes-Free Individuals With Obesity and MASLD: A Randomized Clinical Trial

The BRAVO trial randomized 337 diabetes-free adults with obesity and metabolic dysfunction-associated steatotic liver disease (MASLD) to 1g/day berberine or placebo for 6 months across 11 Chinese hospitals. Mean age was 41.8 years, 65.6% male. The primary outcome was relative percentage change in visceral fat area. The trial was analyzed by intention-to-treat. This is one of the largest and most rigorous berberine RCTs to date, published in JAMA Network Open. The study adds substantial evidence for berberine's metabolic effects in a non-diabetic population with liver steatosis. Results support berberine's role in body composition improvement, though the population studied (Chinese, predominantly male) limits generalizability.

Berberine reduced adiposity in diabetes-free individuals with obesity and MASLD.