From the population and public health perspective, I will hazard a guess about the state of global obesity in 20 years’ time
1. Obesity transition: The trickle of high-income countries entering phase IV of the Obesity Transition (reducing prevalence) will accelerate. The reductions among pre-school children will spread to older children and then youth, especially young women. The downturn to date has mostly occurred in the absence of specific public health efforts to prevent obesity and is often associated with increasing inequities (by disadvantage, ethnicity and rurality). Unless #3 below occurs, this will continue to be the pattern. Scandinavian and high-income Asian countries will lead reductions in obesity prevalence and most middle-income countries will not yet have entered phase IV.
2. Ultraprocessed foods (UPFs): In 20 years, giving children UPFs in schools will acquire the same status as teachers smoking in the classroom. The evidence of harm will be incontrovertible; in Australia and New Zealand, schools will ban UPFs, but; children from disadvantaged households will still be exposed to UPFs for the same reasons they are currently exposed to tobacco smoke.
3. Dealing with inequities: Only countries that deal with the underlying drivers of societal inequities in wealth, education and justice will see major improvements in obesity prevalence and obesity inequities. This will also entail de-powering the commercial influences over policy-making and implementing pro-equity policies (like bans on marketing and taxing UPFs). New Zealand will make more progress than Australia as Māori gain more influence in governance.
4. Climate change and sustainability: The social momentum for sustainable eating will be the dominant determinant of dietary trends as the consumption of UPFs, red meat and dairy declines. All ANZOS catering will be vegetarian and UPF-free with a small, special-request section to the side for obligate carnivores.