Helping Youth Breathe Easier: A Story of Empowerment and Healing in Asthma Care

Mary was a 13-year-old Hispanic girl with obesity who came to my clinic with a note from her school. Her request was simple — she wanted to be excused from gym class. “It’s my asthma,” she said, explaining that every time she tried to run or play, her chest tightened and she felt embarrassed when she had to stop. Her mother nodded in agreement; she didn’t want her daughter to “push too hard” and end up in the emergency room. 

As I listened, I sensed the quiet complacency that had settled in — both Mary and her mother accepted that her asthma would dictate what she could and couldn’t do. Yet, physical activity was exactly what her body needed, not only to strengthen her lungs but also to help manage her weight and overall health. Instead of signing the excuse note, I asked if we could focus on optimizing Mary’s asthma control to help her participate safely in gym class. 

We reviewed her asthma medications, adjusted her inhaler use, and talked about how taking her quick-relief medicine before gym class could help prevent exacerbations. I reassured both Mary and her mom that by improving her asthma control, she could engage in physical activity without fear. They agreed to a trial period. 

When Mary returned to my clinic a few months later, she seemed more at ease. She smiled as she shared that her asthma was better controlled and that she was able to keep up in gym class — something she never thought she could do. What began as a small shift in her care plan had become something larger — a renewed sense of confidence and control over her health. 

Stories like Mary’s remind us that obesity and asthma often intersect in ways that go beyond physiology — shaping how children and their families see themselves, influencing self-esteem, motivation, and daily activities. Today, nearly 1 in 5 U.S. youth are affected bye obesity, with even higher rates among Hispanic and non-Hispanic Black children and adolescents [1–2]. Obesity increases the risk of poor asthma control, leading to more frequent exacerbations and reduced responsiveness to standard inhaled therapies [3–5]. 

Recognizing the dual challenge of managing obesity and asthma, our team launched the Fit Families 4 Life (FF4L) pilot intervention. Working in partnership with a local Federally Qualified Health Center (FQHC) in Riverside and Dr. Redieat Assefa, a former Champion Provider Fellow, we recruited six pediatric patients with asthma and obesity, along with their families. The FF4L pilot targeted children ages 8-12, offering a six-month, multidisciplinary program that included medical optimization of asthma, structured physical activity, medical nutrition therapy and behavioral health support. Early sessions showed promise through clinical tracking measures such as body mass index (BMI) and the asthma control test (ACT) scores. At the same time, we face real-world challenges with family attendance and engagement – prompting adjustments such as transportation support and participation incentives to help families stay connected to the program. Importantly, the program leveraged existing resources available within the health system and local managed care plans, demonstrating that meaningful, sustainable change can occur without new infrastructure by strengthening collaboration. 

This local effort echoes national data showing that family-centered interventions addressing both nutrition and physical activity can improve asthma outcomes and overall health [6–7]. The Global Initiative for Asthma (GINA, 2025) now recommends weight management as a core component of asthma care, noting that even a 5–10% weight reduction can lead to significant improvements in breathing and quality of life [8]. 

Through Fit Families 4 Life, we continue to bridge the gap between healthcare and public health — helping children and families not only manage chronic disease but thrive knowing that change is possible. 

As clinicians and public health partners, we each have an opportunity to recognize how intertwined physical and respiratory health can be — and to empower families through small, meaningful changes. Programs like Fit Families 4 Life show that collaboration and compassion can spark healthier futures, one family at a time. 

Dr. Trang Hoa is a pediatrician who currently serves as the Medical Director at California Children’s Services (CCS) in Riverside County. She is dedicated to enhancing accessibility and equity in children’s healthcare. She believes that small improvements in care can make a big difference in the lives of children and families. 

Dr. Lanelle (Lani) Nakamura is a medical consultant for California Children’s Services (CCS) in Riverside County. Her clinical experience as a pediatric hematologist/oncologist and pulmonary hospitalist inspired her to expand her patient advocacy in her current position to champion access to healthcare.

References

1. GBD 2021 US Obesity Forecasting Collaborators. Lancet. 2024;404(10469):2278–2298. National-level and state-level prevalence of overweight and obesity among children, adolescents, and adults in the USA, 1990–2021, and forecasts up to 2050 - The Lancet

2. AAP Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics. 2023.  Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity | Pediatrics | American Academy of Pediatrics

3. Peters U, Dixon AE, Forno E. Obesity and Asthma. J Allergy Clin Immunol. 2018;141(4):1169–1179. Obesity and asthma - Journal of Allergy and Clinical Immunology

4. Reyes-Angel J et al. Obesity-related Asthma in Children and Adolescent.  Lancet Child & Adolescent Health. 2022;6(10):713–724. Obesity-related asthma in children and adolescents - The Lancet Child & Adolescent Health

5. Ahmadizar F et al. Childhood Obesity in Relation to Poor Asthma Control and Exacerbation: a Meta-Analysis.  Eur Respir J. 2021.  Childhood obesity in relation to poor asthma control and exacerbation: a meta-analysis - PubMed

6. Farhangi MA et al.  Weight Loss and Asthma Control:  A Systemic Review of Randomized Controlled Trials.  Obesity Reviews. 2025;26(7):e13907.  Weight loss and asthma control: A systematic review of randomized controlled trials - Farhangi - 2025 - Obesity Reviews - Wiley Online Library

7. Willeboordse M et al. A Multifactorial Weight Reduction Programme for Children with Overweight and Asthma:  A Randomized Controlled Trial.  PLoS One. 2016;11(6):e0157158.  A Multifactorial Weight Reduction Programme for Children with Overweight and Asthma: A Randomized Controlled Trial - PubMed

8. Reddel H et al. Global Initiative for Asthma (GINA) Report. 2025.  2025 GINA Strategy Report - Global Initiative for Asthma - GINA