Background Few studies have examined how developing obesity in early adulthood affects the course of asthma. Objective We analyzed lung function and asthma impairment and risk among non-obese children with asthma, comparing those who were obese in young adulthood to those who remained non-obese. Methods Post-hoc analysis of 771 subjects with mild-moderate asthma who were not obese (pediatric definition, body mass index (BMI) <95th percentile) when enrolled in the Childhood Asthma Management Program at ages 5–12 years. Subjects were then followed to age ≥ 20 years. For visits at ages ≥ 20 years, spirometry values as percent predicted and recent asthma symptom scores and prednisone exposure were compared between 579 subjects who were non-obese at all visits and 151 who obese (adult definition of BMI ≥ 30 kg/m2) on at least one visit (median number of visits when obese = 4, IQR 2–7). Results Compared to participants who were non-obese (BMI 23.4 ± 2.6 kg/m2), those who became obese (BMI 31.5 ± 3.8 kg/m2) had significant decreases in FEV1/FVC (p<0.0003) and FEV1 (p = 0.001), without differences in FVC (p=0.15) during visits at ages ≥ 20 years. For each unit increase of BMI, FEV1 percent predicted decreased by 0.29 (p=0.0009). The relationship between BMI and lung function was not confounded by sex or BMI at baseline. Asthma impairment (symptom scores) and risk (prednisone use) did not differ between the two groups. Conclusion Becoming obese in early adulthood was associated with increased airway obstruction, without impact on asthma impairment or risk.

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Postural orthostatic tachycardia syndrome (POTS) is a debilitating condition affecting the autonomic nervous system that causes a series of symptoms, such as blurred vision, brain fog, chest pain, headaches, shortness of breath, fatigue, syncope, and rapid heart rate. These symptoms can lead to diminished daily activity, daytime fatigue, poor sleep quality, and increased suicidal tendencies. Among the physical symptoms, POTS patients present decreased quality of life, increased prevalence of depression, and elevated anxiety. This case study documents an interdisciplinary approach to treating a 39-year-old female POTS patient with an 8-week intervention program and a further 4-week follow-up. The intervention investigated the combined effects of Functional Imagery Training and physical exercise on the patient’s quality of life. Following completion of the program, the subject improved in all four quality-of-life components, and this change was maintained over time when compared with baseline measures. The program demonstrated that high levels of exercise adherence beyond the intervention can be achieved when combining Functional Imagery Training and exercise, regardless of the exercise-intolerant characteristics presented by a POTS patient.