Inclusion Criteria:

Participants will meet all of the following:

• Age: 18-70 years of age;
• Obesity: BMI of 30.0-39.9 kg/m2 (due to safety issues surrounding medical treatment and engaging in unsupervised physical activity for persons with BMI > 40);

• Physician-diagnosed asthma that is poorly controlled:

  • a doctor's diagnosis of asthma on the current medical problem list;
  • currently taking anti-asthma medications;
  • >1 control problems identified using the modified ATAQ (see 5.3.4.);
  • Demonstrable airway reversibility.
• Seen in primary care at Kaiser at least once in the preceding 24 months;
• KPNC member for >1 year.

Exclusion Criteria:

Any of the following will exclude participants from the study:

• Inability to speak, read or understand English;
• Intermittent asthma, defined as either seasonal asthma or (daytime asthma symptoms < 2x/week and nocturnal symptoms < 2x/month and no use of long-term control medications);
• Diagnosis of COPD (emphysema or chronic bronchitis) on the current medical problem list or suggested by spirometry at baseline;
• Unwilling to attempt weight loss, including unwillingness to perform self-monitoring;
• Body weight change (+/-) > 10 pounds or use of weight-loss medications in the preceding 3 months;
• Inability to perform pulmonary function tests by spirometry in a consistent manner;
• Significant medical co-morbidities, including uncontrolled metabolic disorders (e.g., thyroid, diabetes, renal, liver), unstable heart disease, heart failure, and ongoing substance abuse;
• Diagnosis of psychiatric disorders that would limit adequate informed consent or ability to comply with study protocol;
• Regular use of medications that can cause weight gain (e.g., oral corticosteroids, insulin, certain oral hypoglycemics, certain antidepressants, etc.);
• Under treatment for cancer or another condition that may prevent completion of follow-up;
• Diagnosis of a terminal illness and/or in hospice care;
• Use of a pacemaker or other implanted medical devices;
• Pregnant, planning to become pregnant, or lactating;
• Actively enrolled in a care management program focused on weight loss at Kaiser or elsewhere;
• Already enrolled or planning to enroll in a research study that would limit full participation in the study or confound the observation and interpretation of the study's findings;
• Family household member already enrolled in the study;
• No longer receiving primary care from Kaiser, or planning not to do so within the study period;
• PCP determination that the study is inappropriate or unsafe for the patient;
• Investigator discretion for clinical safety or protocol adherence reasons.