Inclusion criteria |
   * Age (as of date of enrollment) |
- Lower age limit: 18 years |
- Upper age limit: 70 years |
   * Gender: Both men and women |
   * Race/ethnicity: All racial and ethnic groups |
   * Body mass index 30.0-44.9 kg/m2 |
   * Suboptimally controlled asthma: |
- Documented diagnosis of asthma on the current medical problem list |
- Currently prescribed an anti-asthma medication |
- Score <20 on the Asthma Control Test [75] |
- Demonstrable airway reversibility |
   * Kaiser member for ≥ 1 year |
   * Able and willing to enroll and provide written, informed consent, i.e., to: 1) meet the time and data collection requirements of the study; 2) be randomized to one of the two intervention arms; 3) adhere to the recommendations of the study intervention as assigned; 4) participate in follow-up for 12 months; and 5) allow extraction of relevant information from their medical records. |
Exclusion criteria |
   * Inability to speak, read or understand English; |
   * Intermittent asthma, defined as either seasonal asthma or (daytime asthma symptoms <2×/week and nocturnal symptoms <2×/month and no use of controller medications); |
   * Diagnosis of COPD (emphysema or chronic bronchitis) suggested by patient report of doctor diagnosis, spirometry, and smoking history; |
   * Use of weight-loss medications in the past 3 months; |
   * Initiation or change of antidepressant medication within the past 3 months; |
   * Regular use (>5 days/month) of the following medications: oral corticosteroids, insulin, oral hypoglycemics, anti-psychotics, and mood stabilizers; |
   * Currently enrolled in a group or individual intervention program that overtly aimed at weight loss, nutrition and/or physical activity at Kaiser or elsewhere; |
   * Planning to undergo bariatric surgery during the study period; |
   * Inability to perform pulmonary function tests by spirometry in a consistent manner; |
   * Having a medical or physical condition that makes moderate intensity physical activity (like a brisk walk) difficult or unsafe; |
   * Significant medical co-morbidities, including uncontrolled metabolic disorders (e.g., thyroid, renal, liver), diabetes, heart disease, stroke, and ongoing substance abuse; |
   * Hospitalization for psychological or emotional problems within the past two years; |
   * Diagnosis of cancer (other than non-melanoma skin cancer) that is/was active or treated with radiation or chemotherapy within the past 2 years; |
   * Diagnosis of a terminal illness and/or in hospice care; |
   * Currently pregnant, lactating, or planning to become pregnant during the study period; |
   * Already enrolled or planning to enroll in a research study that would limit full participation in the study or confound the interpretation of the study's findings; |
   * Family/household member of another study participant or of a study staff member; |
   * No longer a Kaiser patient or planning to transfer care outside of Kaiser during the study period; |
   * PCP determination that the study is inappropriate or unsafe for the patient; |
   * Investigator discretion for clinical safety or protocol adherence reasons. |