Justine Chinn

All Publications

• Social Vulnerability and Age at Sleeve Gastrectomy among Adolescents: Does ZIP Code Make a Difference? - A COSMIC Retrospective Study OBESITY SURGERY Rodrigues de Oliveira Filho, J., Pratt, J. S. A., Chinn, J. O., Bowen-Jallow, K., Hornick, M., Griggs, C. L. 2026

  View details for DOI 10.1007/s11695-025-08475-3

  View details for Web of Science ID 001655830500001

  View details for PubMedID 41501578

  View details for PubMedCentralID 9805112

• Pediatric metabolic and bariatric surgery: When is the right time to operate? Current problems in pediatric and adolescent health care Shacker, M., Chinn, J., Pratt, J. S., Fell, G. L. 2025: 101882

  Abstract

  Pediatric obesity is a growing epidemic associated with serious long-term health consequences, including diabetes, cardiovascular disease, and reduced life expectancy. Metabolic and bariatric surgery (MBS) is a safe, effective, and durable treatment for adolescents with severe or refractory obesity; however, it remains significantly underutilized. As a consequence, children with severe obesity and associated comorbidities progress to an advanced stage of disease that can be even more challenging to treat than in adults. Current evidence demonstrates that MBS in adolescents achieves comparable or even superior weight loss and comorbidity resolution compared to adults, with favorable long-term safety profiles. In select cases, GLP-1 receptor agonists (GLP-1RAs), may be used as an adjunct to MBS. Current evidence for GLP-1RA use in the preoperative period is limited, although when reinitiated early in the postoperative period, they may be associated with improved weight loss outcomes. Despite strong guideline support, <0.05 % of eligible children undergo MBS, likely due to poor access to adolescent MBS centers, limited insurance coverage, and a lack of awareness or misinformation surrounding MBS, among other causes. Multidisciplinary support including preoperative teaching, mental health services, and long-term postoperative follow-up is essential to the success of the procedure. Further research is needed to better characterize the disparities in access, improve outreach and education efforts, combat the stigma associated with adolescent MBS, and address this growing public health crisis.

  View details for DOI 10.1016/j.cppeds.2025.101882

  View details for PubMedID 41344950

• The impact of preoperative antiobesity medications on weight loss in adolescents undergoing metabolic and bariatric surgery - a COSMIC study. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery Chinn, J. O., Shacker, M., Brennan, K. A., Kochis, M., Stetson, A., Bizimana, C., Rodrigues de Oliveira Filho, J., Hornick, M. A., Pratt, J. S., Abu El Haija, M., Griggs, C. 2025

  Abstract

  While new medications are transforming the management of obesity, their association with outcomes in adolescents undergoing metabolic and bariatric surgery (MBS) is not clear.The objective was to determine how preoperative prescription of antiobesity medications (AOMs) is associated with postoperative weight loss after MBS.The study was conducted using data from 3 academic children's hospitals, spanning the period from March 2013 to September 2024.This is a retrospective review in which demographics, obesity-related diseases, preoperative and postoperative weight and body mass index (BMI) were compared between patients who were treated preoperatively with topiramate or glucagon-like peptide-1 receptor agonists (GLP-1RAs) and those who were not. Statistical analyses included Wilcoxon rank-sum, Pearson's χ2, and Fisher's exact tests, plus 1:1 propensity score matching and multivariable linear regression sensitivity models adjusting for time-to-surgery.Of 324 patients, 22 were treated with topiramate and 30 with a GLP-1RA. Rates of obesity-related diseases were similar. Patients on GLP-1RA lost weight from first consultation to surgery (-2% BMI), while those on no medication gained (+1% BMI) and those on topiramate remained stable (0%, P = .023). There was no difference in weight/BMI at the time of surgery; however, patients pretreated with medications lost less weight than those not taking medications at 6 months (no medications: -20% BMI reduction; GLP-1RA: -18%; topiramate: -17%, P = .017) and 12 months (no medications -23% BMI reduction, GLP-1RA -15%, topiramate -17%, P = .015). From initial consultation to 12 months after surgery, the differences in weight loss between groups were not significant (P = .072).Preoperative exposure to topiramate or GLP-1RA was associated with less postoperative weight loss, despite similar starting weights/BMIs. Total weight loss from consultation through 12 months did not differ significantly between groups. These findings raise important questions regarding the use and timing of obesity management medications in relation to surgery for adolescents.

  View details for DOI 10.1016/j.soard.2025.10.014

  View details for PubMedID 41353013

• The impact of social determinants of health on adolescent metabolic and bariatric surgical outcomes. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery Chinn, J. O., Herdes, R. E., Shacker, M., Santos, V., Fell, G. L., Pratt, J. S. 2025

  Abstract

  Prior research has shown higher rates of complications across a broad spectrum of surgeries in pediatric patients with higher Social Vulnerability Index (SVI).This study aims to compare how SVI impacts outcomes in adolescents undergoing metabolic and bariatric surgery (MBS).Academic Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program-adolescent accredited care center METHODS: We performed a retrospective cohort study of 126 adolescents and young adults undergoing laparoscopic sleeve gastrectomy between September 2014 and April 2021. Comparative analysis was performed for demographics, percent total body weight loss (%TBWL), and complications between those with high (≥ .75) and low (<.75) SVI.There were 47 patients in the high SVI group and 79 in the low SVI group. Age at surgery, gender, primary language, and insurance type were similar between groups. Preoperative weight and body mass index (BMI) were higher in the high SVI group compared to the low SVI group (145 kg vs 136 kg, P = .033, BMI 52 vs 46, P < .001). Average distance to the hospital was similar (82 miles in high SVI group vs 100 miles in low SVI group, P = .079). The high SVI group had a trend towards a higher percentage of patients who identified as Hispanic/Latino (64% vs 47%, P = .064) and less patients who identified as white (28% vs 51%, P = .054). There was no significant difference in mean %TBWL at 3 months, 6 months, or 12 months (23% in high SVI group (N = 40) compared to 22% in low SVI group (N = 66), P = .4). Complication rates were low in both groups, with no difference between SVI groups (6.5% vs 5.1%, P = .707). While the number of patients with long-term data decreased over time, there was no difference in %TBWL at 2, 3, or 4 years after surgery.Despite a diverse patient population and significant geographic barriers, the outcomes between high and low SVI in this cohort were comparable. Continued efforts need to be made to expand access to MBS for socioeconomic disadvantaged adolescent patients with obesity.

  View details for DOI 10.1016/j.soard.2025.11.009

  View details for PubMedID 41339175

• Timing of Antiobesity Medications and Adolescent Metabolic and Bariatric Surgery. JAMA surgery Chinn, J. O., Shacker, M., Brennan, K. A., Esquivel, M. M., Pratt, J. S. 2025

  View details for DOI 10.1001/jamasurg.2025.4430

  View details for PubMedID 41123888

  View details for PubMedCentralID PMC12547670

• ASO Visual Abstract: Comparison of Two Wireless Localization Technologies for Removal of Nonpalpable Breast Lesions-SCOUT® Radar Reflector and Pintuition® Magnetic Seed. Annals of surgical oncology Chinn, J., Earley, M., Dashevsky, B. Z., Stone, K., Thompson, C. N., Bao, J. 2025

  View details for DOI 10.1245/s10434-025-18560-7

  View details for PubMedID 41099957

• Does the MBSAQIP Bariatric Surgical Risk/Benefit Calculator Accurately Predict Weight Loss in Adolescents? Obesity surgery Kochis, M. A., Chinn, J. O., Nzenwa, I. C., Brennan, K. A., Pratt, J. S., Griggs, C. L. 2025

  Abstract

  BACKGROUND: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) online calculator incorporates individual patient data to predict weight loss up to 1year after MBS, but it was derived from an adult database and has not been validated in younger cohorts. This study evaluates the accuracy of this calculator for adolescent MBS patients and explores patient factors which may be associated with prediction inaccuracy.METHODS: We include patients age≤21 who underwent laparoscopic sleeve gastrectomy at two major academic institutions from 2013 to 2023. Data were stratified between patients age<18 and 18-21. The calculator's predictions were compared to actual weight loss values at 1year. Relationships between various preoperative variables and the difference between predicted and actual weight loss were assessed using correlation, regression, and t-tests.RESULTS: There were 265 patients, with 176 age<18. The correlation coefficients for predicted and actual weight loss were 0.48 for patients age<18 and 0.38 for patients 18-21. On average, the proportion of predicted weight loss actually attained at 1year was 0.73. There were no statistically significant associations between calculator inaccuracy and patient age, sex, preoperative body mass index, or area deprivation index (all p>0.05).CONCLUSIONS: The MBASQIP calculator predictions show weak to moderate correlation with actual weight loss at 1year and should be used with caution when counseling pediatric patients considering MBS. This project underscores the importance of building multi-institutional collaborations and databases specific to the pediatric MBS context.

  View details for DOI 10.1007/s11695-025-08295-5

  View details for PubMedID 41068350

• ASO Author Reflections: From Performance to Preference: Wireless Localization Technologies in Breast Surgery. Annals of surgical oncology Chinn, J., Bao, J. 2025

  View details for DOI 10.1245/s10434-025-18465-5

  View details for PubMedID 41028640

  View details for PubMedCentralID 4933133

• Comparison of Two Wireless Localization Technologies for Removal of Non-palpable Breast Lesions: SCOUTRadar Reflector and PintuitionMagnetic Seed. Annals of surgical oncology Chinn, J., Earley, M., Dashevsky, B. Z., Stone, K., Thompson, C. N., Bao, J. 2025

  Abstract

  BACKGROUND: The SCOUT radar reflector (SCOUT) is a common wireless technology used for removal of non-palpable breast lesions. The Pintuition magnetic seed (Pintuition) utilizes a magnetic marker encapsulated in nickel-free titanium. This is the first study comparing surgical outcomes of SCOUT and Pintuition.METHODS: A retrospective, single-institution review was conducted evaluating lumpectomies and excisional biopsies of non-palpable breast lesions performed between May 2022 and July 2024 utilizing wireless localization for intraoperative guidance. The SCOUT was the only wireless option at our institution prior to June 2023, at which time the Pintuition seed became available. Patients with multiple localizations or oncoplastic reconstruction were excluded. Patient characteristics, procedure type, lesion characteristics, positive margin, and re-excision rates were compared using the Chi-square or Fisher's exact tests for categorical variables and Wilcoxon rank-sum test for continuous variables. Generalized linear models were used to compare surgery length and specimen volume.RESULTS: Of 90 lesions identified, 45 were localized by SCOUT and 45 by Pintuition. Age, body mass index (BMI), surgery type, neoadjuvant therapy, total specimen volume, pathologic cancer size, positive margin, and margin re-excision rates were not found to differ by device. All Pintuition seeds were removed on index operation, whereas one SCOUT was not. Surgery length was significantly shorter for Pintuition cases compared with SCOUT (median 37 min vs. 50 min; p=0.006). One patient in each group required margin re-excision.CONCLUSIONS: Operative time was significantly shorter for Pintuition cases. Pintuition represents a reliable and effective wireless localization technique. Considerations need to be given to nuanced features of each device.

  View details for DOI 10.1245/s10434-025-18354-x

  View details for PubMedID 40946252

• Bariatric Surgery: Improving Access without Compromising Outcomes. Obesity surgery Chinn, J. O., Bartoletti, S., Shen, J. X., Kulhanek, K. R., Shacker, M., Zak, Y., Azagury, D. E., Esquivel, M. M. 2025

  Abstract

  Bariatric surgery pre-operative workup mandates many multidisciplinary visits demanding patient's commitment in time and travel. Due to the COVID pandemic, our bariatric clinic transitioned to a telemedicine model. The objective of this work is to determine the impact of this shift.Our population is adults who underwent gastric bypass or sleeve gastrectomy at a single hospital between 2018 and 2022. We analyzed the impact of telemedicine on demographics, days from consultation to surgery, length of hospital stay, type of procedures, BMI, and complications. Statistical analyses were conducted using χ2 tests for categorical variables and t-test for continuous variables as well as logistic regression.Of 794 patients, 71.3% received in-person care while 28.7% received telemedicine. There were no differences in race, ethnicity, or gender. The average duration from consultation to surgery was longer (p < 0.001) for in-person (551.1 days) compared to telemedicine (375.8 days). The pre-operative BMI was higher for the in-person cohort versus telemedicine (45.5; SD 8.0 vs. 43.9; SD 6.7; p < 0.001), but there was no difference in percent weight loss at 12 months. The average length of stay was longer in the in-person group compared to telemedicine (1.9 vs 1.2 days). There was no difference in readmission or emergency department visit rates.Despite being the best treatment for severe obesity, bariatric surgery remains underutilized. When comparing telemedicine to an in-person model, we found shorter time to surgery, shorter length of stay, and similar outcomes with no difference in weight loss or complications. Telemedicine may be a safe and useful way to improve access.

  View details for DOI 10.1007/s11695-025-08222-8

  View details for PubMedID 40921958

  View details for PubMedCentralID 11325826

• Mild to moderate GERD before sleeve: Can we better predict post-operative GERD? Surgical endoscopy Chinn, J. O., Ruhi-Williams, P., Shacker, M., Esquivel, M. M., Garcia, P., Clarke, J. O., Azagury, D. E. 2025

  Abstract

  Gastroesophageal reflux disease (GERD) can be debilitating for patients after sleeve gastrectomy (SG). However, no clear numerical thresholds have been identified to help predict which patients will develop worsening symptoms post-operatively. We therefore sought to characterize which pre-operative wireless pH testing and endoscopy findings were associated with GERD after SG.Patients with a history of SG and pre-operative wireless pH studies were identified. Abnormal DeMeester score was defined as > 14.7 and abnormal acid exposure time (AET) as > 4% of time with a pH < 4. Clinically meaningful post-operative GERD was defined as GERD symptoms requiring proton pump inhibitor (PPI) therapy. We performed a univariate analysis and a Youden's index analysis to determine when DeMeester score and AET become predictive of post-operative GERD.Of 76 patients included, 41 patients (53.9%) reported pre-operative GERD symptoms. Of those with symptoms, 20% had LA Grade A or B esophagitis, 25% had a hiatal hernia, 56.1% had an elevated DeMeester score, and 58.5% had an elevated AET. Post-operatively, 13.2% (5/38) of patients with pre-operative symptoms required a PPI compared to 6.1% (p = 0.4) in patients without pre-operative symptoms. There was no difference in the rate of post-operative GERD between those with a normal vs abnormal pre-operative DeMeester (13.3% vs 13.0%, p > 0.9). In univariate analysis, abnormal DeMeester score (OR 1.25, p = 0.779), grade A or B esophagitis (OR = 1.70, p = 0.554), or abnormal AET (OR = 1.25, p = 0.779) were not predictive of post-operative GERD. However, a threshold of DeMeester score of ≥ 30 or AET ≥ 10.35 was predictive of post-operative GERD.In patients with moderate GERD, standard cutoffs of abnormal DeMeester score or AET were not predictive of post-operative GERD, however a threshold DeMeester score of ≥ 30 or AET ≥ 10.35 was predictive. Patients with such findings should be particularly counseled about the risk of post-operative GERD and/or offered a Roux-en-Y gastric bypass.

  View details for DOI 10.1007/s00464-025-12091-8

  View details for PubMedID 40877626

  View details for PubMedCentralID 10735086

• Metabolic and bariatric surgery in adolescents compared to young adults: an MBSAQIP database analysis. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery Shacker, M., Chao, S. D., Chinn, J. O., Fell, G. L., Mueller, C. M., Pratt, J. S. 2025

  Abstract

  Metabolic and bariatric surgery (MBS) is a highly durable, safe and effective treatment for severe obesity in adults. However, MBS remains underutilized in the pediatric and adolescent population, likely due to safety concerns of elective surgery in children.We aimed to analyze whether the benefits of MBS outweigh the risks in adolescents when compared to young adults.Multicenter, national database study.Patients aged 10-39 who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Patients with prior foregut surgery were excluded.556,628 patients were identified; 10,883 (2.0%) were aged 10-19 (adolescents), 161,938 (29.1%) were 20-29 (young adults), and 383,807 (69.0%) were 30-39 (adults). Preoperative body mass index (BMI) was clinically similar between groups, though statistically significant due to large sample size (10-19: 46, 20-29: 45, 30-39: 45 kg/m2, P < .001). SG was more common in younger cohorts (10-19: 86%, 20-29: 77%, 30-39: 75%, P < .001). At 30 days postoperatively, adolescents demonstrated marginally greater BMI reduction (10-19: 2.91, 20-29: 2.69, 30-39: 2.53 kg/m2, P < .001). Adolescents had fewer postoperative complications, including surgical site infections, gastrointestinal bleeding, and blood transfusions (P < .001). Among adolescents, SG (aOR: .39, CI: .31-.48, P < .001) was associated with reduced postoperative complications.Adolescents undergoing MBS have BMI reductions similar to those of young adults and have lower rates of complications and readmissions. MBS should be offered as a safe treatment for adolescents to treat morbid obesity with at least similar frequency as it is offered to adults.

  View details for DOI 10.1016/j.soard.2025.08.010

  View details for PubMedID 40946077

• Comparison of Two Non-Radioactive Wireless Localization Technologies for Removal of Non-Palpable Breast Lesions: SCOUT® Radar Reflector and Pintuition® Magnetic Seed Chinn, J., Earley, M., Dashevsky, B., Stone, K., Thompson, C., Bao, J. SPRINGER. 2025: 858-859

  View details for Web of Science ID 001610682000318

• The Impact of Socioeconomic Disadvantage on Metabolic and Bariatric Surgical Outcomes using Area Deprivation Index. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Chinn, J. O., Kulhanek, K. R., Shen, J. X., Shacker, M., Zak, Y., Azagury, D. E., Esquivel, M. M. 2025: 102136

  View details for DOI 10.1016/j.gassur.2025.102136

  View details for PubMedID 40582560

• Pediatric Metabolic and Bariatric Surgery and Anti-Obesity Medications: Weighing Efficacy, Risks, and Future Directions. The Journal of pediatrics Chinn, J. O., Baidal, J. W., Pratt, J. S., Shepard, W. E., Fell, G. L. 2025: 114610

  View details for DOI 10.1016/j.jpeds.2025.114610

  View details for PubMedID 40252955

• The Importance of Sexual History-Taking Within Surgery ACADEMIC MEDICINE Chinn, J. O., Hawn, M. T. 2025; 100 (4): 410-412

  Abstract

  Sexual and reproductive health is an essential part of comprehensive medical care. As the field of medicine becomes more specialized and siloed and the diagnostic workup in surgery more advanced, the risk of anchoring diagnoses and partitioning of care increases. Thus, the fundamentals of a complete patient history and review of each body system remain critical in ensuring that surgeons establish a broad differential diagnosis; provide comprehensive, well-rounded care to patients; and create opportunities for patient counseling and interventions. The article by Coleman and colleagues reports on an intervention that did not result in trainees being more likely to take a sexual history; however, the intervention group did ask significantly more questions regarding sexual health than the comparison group when they did take a sexual history. They highlight that there is a persistent gap in sexual history-taking, and that this results in potential misdiagnoses as well as missed opportunities to counsel patients about sexual and reproductive health. Clinicians have a responsibility to recognize factors that increase risk for their patients and provide appropriate counseling, which they cannot do if they are not asking all the necessary questions, even the difficult ones.

  View details for DOI 10.1097/ACM.0000000000005965

  View details for Web of Science ID 001455250200018

  View details for PubMedID 39752576

• Transforming Clinical Care: The Emergence of Ambulatory Bariatric Surgery for Patients with Obesity Tennakoon, L., Chinn, J., Esquivel, M. LIPPINCOTT WILLIAMS & WILKINS. 2024: S45-S46

  View details for Web of Science ID 001348680700066

• The Impact of Area Deprivation Index on Bariatric Surgical Outcomes Chinn, J., Adams, M., Kulhanek, K. R., Shen, J. X., Tennakoon, L., Bartoletti, S., Azagury, D. E., Esquivel, M. LIPPINCOTT WILLIAMS & WILKINS. 2024: S44

  View details for Web of Science ID 001348680700063