The global prevalence of obesity and asthma has escalated in parallel over recent decades, presenting an intertwined public health crisis. Obesity not only increases the risk of asthma development but also complicates its clinical course by altering respiratory mechanics, immune responses, and treatment responsiveness. Obesity-associated asthma is often more severe, less responsive to corticosteroids, and accompanied by systemic comorbidities such as insulin resistance and metabolic syndrome. Recently, glucagon-like peptide-1 receptor agonists, initially approved for diabetes and obesity, have shown potential in improving asthma outcomes. Preclinical data and early clinical studies suggest that glucagon-like peptide-1 receptor agonists exhibit anti-inflammatory and immunomodulatory effects independent of their metabolic benefits, in addition to a possible role in improving the respiratory function of the large and small airways impaired in obese patients with asthma. This narrative review examines the pathophysiological interplay between obesity and asthma, evaluates the current evidence supporting the use of glucagon-like peptide-1 receptor agonists in this context, and highlights the emerging paradigm of treating asthma as a systemic, multifactorial disease. Targeting metabolic dysfunction with glucagon-like peptide-1 receptor agonists may represent a potential transformative approach for patients with obesity and difficult-to-treat asthma.
