A new report from the Global Wellness Institute, a nonprofit focused on research in preventative health and wellness, found that Americans spent $264.6 billion dollars on physical activity in 2018, far more than any other nation. The United States leads the world in spending for every segment, including fitness classes ($37 billion), sports and recreation ($58 billion), apparel and footwear ($117 billion), equipment and supplies ($37.5 billion), mindful movement, such as yoga ($10 billion), and related technology ($8.1 billion). And yet, according to the academic journal The Lancet, for all of this spending, we rank 143rd globally for actual participation in physical activity. More than 40 percent of Americans fail to meet the global standard of 150 minutes per week of moderate physical activity (e.g., fast-paced walking, gardening) or 75 minutes per week of intense physical activity (e.g., running, strength training).

This data largely mirrors what we know about health care. The U.S. spends, by far, the most money of any developed nation on health care per person but ranks toward the bottom (if not last) on common measures of actual health, such as chronic disease, life expectancy, infant mortality, disability, and drug-related deaths. This is not surprising, given that insufficient physical activity, along with poor diet, is the second leading cause of preventable death, only behind smoking.

Underlying Causes

The Global Wellness Institute listed a few causes for the discrepancy between dollars spent on physical activity in the our country and actual participation: we don’t have enough sidewalks or bike lanes, youth sports have become too expensive and hypercompetitive, we lack a supportive and communal exercise culture.

In addition, the health and fitness industry has become obsessed with complexity. Sometimes this is warranted, but often it’s not. One reason people make things complex is so they can sell them. It’s hard to monetize the basics, but come up with an intricate and sexy-sounding approach to something and people will pay for it. So why are so many of us willing to fork over cash for often unnecessary services? Perhaps because complexity is a way to avoid facing the reality that what really matters for health and fitness is simply showing up and doing the work. Not thinking about it or talking about it. Just doing it.

The more complex you make something, the easier it is to get excited about, talk about, and maybe even get started—but the harder it is to stick with over the long haul. Complexity gives you excuses and ways out and endless options for switching things up all the time. Simplicity is different. You can’t hide behind simplicity. You have to show up, day in and day out, and pound the stone.

What We Can Do About It

It’s time to go back to basics. For nutrition, Michael Pollan famously offered the advice: “Eat food, not too much, mostly plants.” For fitness, I’d like to add: move your body often, sometimes hard, every bit counts.

A common excuse is that people don’t have time to exercise. While this may be true if you’re working multiple jobs and struggling to meet your basic needs, it’s simply not true for the majority of people. A recent study of 32,000 Americans by the think tank Rand found that, on average, Americans have more than 4.5 hours per day of leisure time, the vast majority of which is spent sitting in front of screens. This finding was consistent across income, age, gender, and ethnicity.

Even if you insist that you’re too busy to exercise because you work some kind of important job, you ought to consider reframing exercise as an essential part of that important job. Research shows that regular exercise increases creative thinking and problem-solving, improves mood and emotional control, and enhances focus and energy. There is no line of work that doesn’t benefit from those attributes.

Physical activity is not rocket science, and it doesn’t need to cost billions of dollars. It’s actually quite simple—but simple doesn’t always mean easy. If you need more inspiration or information, below are some past columns of mine that can help you on your path. You can also follow me on Twitter, where I share daily tips and tricks backed by the latest evidence.

Brad Stulberg (@Bstulberg) coaches on performance and well-being and writes Outside’s Do It Better column. He is the bestselling author of the books The Passion Paradox and Peak Performance. Subscribe to his newsletter here.