Powerful medicine: A lifelong passion for nutrition fuels Adam Rotunda.

Thompson, Sarah S.

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When Dr. Adam Rotunda '96 visited his clinical professor's dermatology practice, he was fascinated by a set of photographs. As a young UCLA dermatology resident focusing on skin cancer surgery, he was amazed to see images of research subjects who'd been injected with a substance that seemingly melted the fat under their eyes. A decade later in 2015, that substance--after research and refining by Rotunda--reached the market as Kybella, the first injectable medication approved by the Food and Drug Administration to reduce fat under the chin.

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With Kybella, physicians can now offer patients an alternative to surgery. For Rotunda--who continues to specialize in Mohs micrographic surgery--Kybella's approval is a dream come true after years of research. It's also inextricably linked to a life and career powered by nutrition.

It started with Rotunda's father, a bodybuilder who gave him protein pills as treats so he'd sit still during church. Rotunda looked up to him, and to an overweight older brother who'd transformed himself during a summer spent lifting weights and eating well. Starting at 12, working out became a daily discipline for Rotunda, setting him apart from his peers and focusing his studies on a premed curriculum in Nutritional Sciences.

"I saw the power of nutrition and working out," he says. "It was very tangible."

That led Rotunda to medical school and his dermatologic surgery residency at UCLA. There, something in Dr. Glynis Ablon's research on the fat-melting injections caught his eye: the active ingredient was purportedly phosphatidylcholine (PC), a nutritional supplement Rotunda knew from his post-workout protein shakes. Another ingredient was sodium deoxycholate (DC), an intestinal bile salt that helps digest fat. Intrigued, Rotunda wrote up Ablon's findings for peer review and publication; the article immediately became controversial.

Most of Rotunda's teachers and peers advised him to quit the work, but one professor, Dr. Michael S. Kolodney, urged him to uncover why and how the injections worked. "In the lab, Michael told me, 'Adam, this is going to define your career,'" says Rotunda.

After two years of experiments, Rotunda and Kolodney discovered that DC, not PC, was the active ingredient. Following a r successful clinical trial. Rotunda and Kolodney patented their work. In 2005, Kolodney presented their findings at a biotech conference, where Kythera Biopharmaceuticals (now Allergan) took note, buying the rights and shepherding the drug through the long approval process.

Today, Kybella's future is in Allergan's hands, leaving Rotunda to focus on his surgery practice and being a mentor for Cornell students. Rotunda credits Dr. Virginia Utermohlen, former associate professor in nutritional sciences, with encouraging him to apply to the Urban Semester Program, where he found his calling with Dr. Philip S. Barie at the Weill Cornell Surgical Intensive Care Unit.

"I had a very different perspective going back to Cornell after that," says Rotunda. "The work had greater meaning beyond the GPA because there was a purpose, a goal."

Rotunda is making a similar impact on his undergraduate summer interns--integrating them into his medical team, offering opportunities to conduct clinical research, and encouraging them to develop relationships with their patients. "My time with Dr. Rotunda crystallized my goal of becoming a doctor and conducting surgery," says former intern Xun Yang (Leo) Hu '16. "His words gave me the confidence to know that I can handle the years of schooling ahead, the inevitable failures, and endless hours of work."

Above all, Rotunda's mentoring is shaped by his experience after being ridiculed for doing the 'wrong' kind of studies too early in his medical career. "It will be difficult as you pave your path forward," he says. "Find good mentors along the way. They may change your life."