(Bloomberg) -- Obese people who have weight-loss surgery gain at least six years of health benefits that include fewer diabetes cases and lower cholesterol and blood pressure. Even so, their medical costs didn’t drop.

While the advantages linked to diminished fat were found to be durable over six years in a study published Tuesday, a second report tied the surgery to complications such as gallstones and anemia that raised how much patients spent over the same time period. The research was included in an obesity theme issue of the Journal of the American Medical Association.

More than 500 million people worldwide are obese, according to the World Health Organization. Other research in the journal found that children with high levels of bisphenol A, a chemical in consumer products, were twice as likely to be obese and that some types of body fat are more dangerous than others. The surgery findings suggest the procedures are underused, said Philip Schauer, at the Cleveland Clinic in Ohio.

“Despite the somewhat overwhelmingly positive study results, surgery rates haven’t changed,” with about 1% of those who qualify getting an operation, said Schauer, director of the clinic’s Bariatric and Metabolic Institute. “We’re not anywhere close to coming up with effective prevention strategies.”

Schauer, interviewed by telephone, wasn’t involved in either of the surgery studies.

The journal’s theme issue coincides with a report this week by two public-health foundations that said obesity will continue to rise in the U.S., potentially adding $66 billion in expenses to the nation’s health care bill. The Obesity Society, based in Silver Spring, Md., is also set to hold its annual meeting starting today in San Antonio.

By 2030, more than 60% of adults in 13 states may be obese, with all states having obesity rates of more than 44 percent under current trends, according to the report from the Trust for America’s Health and Robert Wood Johnson Foundation.

A person with a body mass index of at least 30 is considered obese, according to the National Institutes of Health in Bethesda, Md. The BMI is calculated using height and weight. A man who is six-foot tall who weighed more than 220 pounds would be considered obese using the formula.

The number of severely obese people in the U.S. is growing faster than those with moderate obesity, according to Ted Adams from the University of Utah’s School of Medicine in Salt Lake City, who led the study on weight-loss surgery’s long-term health benefits.

Drug therapy and lifestyle changes have been largely ineffective, so the weight-loss surgery investigators examined the results of the procedure in 1,156 volunteers. The patients who underwent gastric bypass surgery lost an average of 28% of their body weight, while those who didn’t get surgery stayed the same or even gained a few pounds, the study found.

Almost two-thirds of the surgery patients saw their blood sugar return to normal levels, while hypertension, cholesterol and triglyceride all declining.

Researchers were surprised by the results of a separate study that weighed cost benefits from the surgery, said Martin Neovius from the Karolinska Institute in Sweden, the lead author. The study tracked 2,010 adults who underwent weight loss surgery between 1987 and 2001, and compared their results to similar people who didn’t get surgery.

The researchers found that surgery patients spent 54 days in the hospital in the two decades after their operations, compared with 40 days for those in the comparison group. For the first six years, they were hospitalized an average of 1.7 days each year, compared with 1.1 days for their overweight peers who didn’t have surgery, and had more doctor visits for things other than routine care.

The operation did reduce the amount of money patients spent on drug costs after the first six years. Surgery patients spent $930 annually, compared with $1,123 for the comparison group, in years seven to 20, the study found. The biggest difference was in lower spending for diabetes and heart disease drugs.

“Based on our findings, bariatric surgery appears to result in greater health benefits than conventional obesity treatment, but at a higher cost over the time of the study,” the researchers concluded. “A formal cost-effectiveness analysis is needed to quantify” the exact costs associated with surgery, they said.

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