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Incretin-like drugs mimic these hormones, and while we do not have any head-to-head trials, you can see from the informative Figure below, summarizing best results of this family of drugs to date, moving from single agonist GLP-1 to double and then triple (GLP-1-GIP-GCG), there is incremental body weight loss

The fundamental distinction lies in the mechanism of action: GLP-1 agonists are receptor-specific molecules that directly stimulate GLP-1 receptors, while berberine exerts its metabolic effects primarily through AMPK activation and other pathways that do not involve direct GLP-1 receptor engagement

K., & Hartman, M

A 2021 randomized controlled trial did find increased GLP-1 activity in subjects taking berberine, but could not determine if berberine caused the effect directly or indirectly