“We are under-exercised as a nation; we look instead of play; we ride instead of walk.”
—John F. Kennedy, Sports Illustrated, 1960

In 1960, then-President-elect John F. Kennedy issued a striking warning: Americans were becoming physically unfit, and this trend threatened not just individual health, but the vitality of the nation itself. He saw physical activity as foundational to our strength—not just as a people, but as a country. Over sixty years later, his words feel more urgent than ever.

Despite all we have accomplished in medicine, technology, and education, we have not addressed one of the simplest pillars of public health: movement.

The state of physical fitness in America

In 2025, the statistics are bleak. Only 24 percent of U.S. adults meet the CDC’s guidelines for aerobic and muscle-strengthening activity. Over 42 percent are obese, with another 30 percent overweight. One in five children is now considered obese. Meanwhile, the average American spends more than nine hours each day sitting—at work, at home, and in front of screens.

These numbers are not just academic—they reflect a deepening public health crisis. Conditions linked to physical inactivity, such as heart disease, diabetes, and certain cancers, remain leading causes of death. Yet despite clear evidence, exercise remains strikingly underemphasized in clinical medicine.

What I saw in medical school

As a recent medical school graduate preparing to enter residency in physical medicine and rehabilitation, I was struck by how little formal attention was given to physical activity as a core treatment strategy. We learned to memorize the minutiae of disease pathways and master pharmacologic protocols. But when it came to prescribing movement, the message was vague—almost peripheral.

We often used the phrase “lifestyle modifications,” bundling together diet, sleep, stress, and exercise into one imprecise recommendation. We understood these things mattered but rarely examined them with the same depth we applied to medications or procedures. I remember devoting weeks to the study of glucose metabolism, yet spending almost no time learning how a 30-minute walk could lower blood sugar in patients with Type 2 diabetes. We focused heavily on cardiovascular pharmacotherapy but paid little attention to how aerobic training could improve heart function and reduce morbidity.

This educational gap inevitably spills over into practice. Many physicians, eager to support their patients, feel ill-equipped to offer specific, personalized advice on physical activity. In a system that prioritizes quick visits and tangible interventions, it is easier to write a prescription than to engage in a meaningful conversation about movement.

Exercise: the most underused treatment we have

We know that movement is medicine. Regular physical activity improves cardiovascular function, enhances metabolic health, reduces depression and anxiety, improves cognitive performance, supports immune function, and even contributes to longevity and skin health. The benefits are comprehensive, and the side effects minimal.

And yet, we continue to underutilize it—not just in clinics, but across all levels of society.

To change this, we need more than good intentions. We need to integrate exercise physiology and prescription into medical training. We need health care systems that reward prevention, not just intervention. We need providers who feel confident in delivering movement-based recommendations with the same clarity they give medications.

But we also need to look further upstream.

Physicians must advocate for physical education reform

One of the most disheartening public health trends over the past two decades has been the quiet dismantling of physical education in schools. In pursuit of academic performance metrics, gym classes have been shortened, deprioritized, or cut altogether. We have replaced recess with remediation and swapped movement for test prep.

If we are serious about tackling chronic disease and building a healthier next generation, we must reverse this trend.

As physicians, we have a responsibility not only to treat disease but to advocate for the systems that prevent it. That means supporting a national revival of physical education—one that prioritizes lifelong movement literacy, not just competitive athletics or outdated fitness tests. Movement should be a fundamental part of a child’s education, just like reading and math.

A call to move forward

This is not about choosing between injections and exercise, procedures and prevention. It is about creating a culture of care that embraces both. As I begin my training in a specialty that bridges intervention and rehabilitation, I believe we can do more to put movement at the center of health—not just as a reactive measure, but as a proactive prescription.

JFK’s message was not about nostalgia for the gym class of the past. It was a call to reclaim something deeper: the idea that a strong nation requires strong bodies, and that health is a shared responsibility.

We are still, in many ways, a nation of spectators. But we do not have to be. The prescription is clear. Now we just need to write it.

Alexandre Bourcier is a physiatry resident.