The first pharmaceutical therapy approved by the FDA for the reduction of submental fat is ATX-101 also known as deoxycholic acid; better known as Kybella. It is being used for submental fat otherwise known as the double chin.

So what is it and where did it come from?

Deoxycholic acid is a bile acid that is already produced in the body and used to break down dietary fats that are consumed when we eat. The deoxycholic acid physically destroys the cell membrane of fat cells causing them to breakdown. Once the fat cells are broken down cells referred to as macrophages eliminate cellular debris and lipids thereby clearing them through natural processes. Fibroblasts then appear and form collagen. ATX-101 is biologically identical to deoxycholic acid; however it is synthesized.

Most of the adverse events noted with ATX-101 were local reactions at the injection site. These included bruising, pain, numbness, swelling, redness, nodule formation, and itching.

The success of the drug is based upon use of scales that define the fullness of fat under the chin. It was found that most patients experienced improvement in the fullness by using the scale of at least 1 point.


The scale is shown here:

Score                                Submental Fat Description

  • Absent Submental Convexity, No localized submental fat evident
  • Mild Submental Convexity, Minimal localized submental fat
  • Moderate Submental Convexity, Prominent, localized submental fat
  • Severe Submental Convexity, Marked, localized submental fat
  • Extreme Submental Convexity


As you can see it is not a miracle drug and is not available for use in other parts of the body as it requires many injections to achieve an improvement in the score by 1 point.


The effects of ATX-101 were found to last up to 4 years following treatment. The use of ATX-101 should strictly be thought of as a cosmetic procedure as its use has no effect on the weight and metabolism of the body.


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