The concomitant increase in obesity and asthma in recent years has led to the classification of two obese-asthma phenotypes, characterized by the age of asthma onset and atopy. Asthma tends to be more severe, harder to control, and more resistant to standard medications among members of these two groups. Because of the limited effectiveness of inhaled corticosteroids, dietary changes and weight loss measures must be considered in the management of these patients. Furthermore, comorbidities such as depression and obstructive sleep apnea must be addressed to provide optimal care for this group of difficult-to-control asthmatics.