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The answer is that such large clinically-verified doses of berberine come with problems

doi: 10.1038/s41366-025-01859-6

Preclinical Models of Cocaine and Psychostimulant Use Disorders Cocaine and related psychostimulants such as amphetamines exert their addictive potential primarily via enhanced dopaminergic signaling in mesolimbic circuits, particularly through increased dopamine availability in the NAc

The condition, which can be difficult to treat, causes severe nausea, vomiting and abdominal pain

JAMA (2018) 319:24154

10 Longterm observations that patients undergoing bariatric surgery show a reduced incidence of cancer in comparison with age and sexmatched subjects 11 suggest that treatment of obesity, when producing a relevant weight loss, could reduce the incidence of malignancies