Beyond GLP-1s: Weight Loss Alternatives to Consider

Reviewed 5/14/26 by the NatMed Clinical Team

Top Takeaways

For patients seeking weight loss without Rx meds, berberine, the ketogenic diet, and intermittent fasting all show some evidence of benefit – but none is a universal solution. Matching the approach to the patient's lifestyle, health status, and medication profile is key.

Buzz around GLP-1s for weight loss isn’t waning. But many patients are looking for other solutions that don’t involve medications. Here's what the evidence says about three popular options.

Is berberine worth a shot for weight loss?

Maybe, but results are usually modest. A meta-analysis of 12 small clinical studies shows that taking berberine 300-1500 mg daily for up to 2 years reduces body weight by around 2 kg or about 4.5 lbs. But most of the studies included were small and of mixed quality, limiting the overall findings. And while it’s been used safely in doses up to 1500 mg daily for up to 6 months, keep an eye on product quality and drug interactions. Berberine products aren’t verified by most reputable third-party certifiers, and it moderately inhibits cytochrome P450 3A4 (CYP3A4) – it’s been shown to increase blood levels of drugs like cyclosporine.

Is the ketogenic diet a good option for weight loss?

It can be. Studies in overweight and obese adults show that limiting carbohydrate intake to 20 grams daily for 6-12 months, and not limiting calories, reduces body weight by 10-30% compared to baseline. It’s likely safe for most people when used for up to 1 year – longer-term safety isn’t clear. The downside? While there are many variations of the keto diet, it’s not for everyone – most require long-term maintenance of severe carbohydrate restriction, typically no more than 20 grams daily, and sticking to this can be challenging.

Should patients try intermittent fasting for weight loss?

If it works for their lifestyle, it might be helpful. Clinical research shows that intermittent fasting for 1-24 months can reduce weight by almost 15% in patients with obesity – but it’s not clear if it benefits those who don't meet that threshold. The specific intermittent fasting regimens followed in most clinical studies include alternate-day fasting, time-restricted fasting, and 5:2 or 4:3 periodic fasting. For example, the 5:2 approach includes two days each week with very low caloric intake. It seems to be safe as long as nutritional needs are met.

What’s the bottom line?

There’s no one-size-fits-all when it comes to weight loss. Help patients decide which approach best fits their lifestyle and goals. For deeper dives into any of these, check out our full NatMed Pro monographs, and take advantage of our NatMed Pro CE courses, including Weight Loss Supplements, Diets and Dietary Modifications, as well as GLP-1 Agonists: Supporting Success with Nutrition and Lifestyle Considerations for patients who go the GLP-1 route.