It seems to me that people here spend way more time out of their homes than inside. Want to play some games? Go to a PC Bang (a computer/gaming cafe). Want to study or hang out with friends? Go to a cafe or a restaurant. And although there are many cars, these are not the main mode of transportation. While people are out all day, the many hills, stairs, and inclines will provide plenty of exercise!
I think the biggest challenge is the lack of land. There just isn't enough space for people to stretch out like in the US. Being here really made me realize just how big the US actually is! In addition to that, especially here in Seoul, the land they do have is definitely NOT flat and easy to work with. Koreans also have to decide how to balance their need for more space for a growing economy with preserving their history and important cultural sites.
To adapt to their lack of space, Koreans have a few ideas. First, they build up! It may seem obvious at first; just go to any large city in the US and you will see skyscrapers and large apartment buildings, but it's on a whole new level in Seoul. Everywhere you go, restaurants are stacked on top of one another with stores above that and apartments above that. Many places that are only a few floors high don't have stairs either so prepare for a workout! Second, Koreans also aren't afraid to build right up the side of a mountain. Instead of transforming their environment to better suite their construction like in the US, here they work with the environment and adapt to the sometimes sharp changes in height.