Respiratory Muscle Training to Improve Cerebrovascular and Immune Function

Inclusion Criteria: * Body mass index greater than or equal to 30 kg/m2 * Waist circumference greater or equal to 88 cm for females and greater than or equal to 102 cm for males Exclusion Criteria: * Not weight stable (\<5% change in body mass over the past six months) * Overt cardiovascular, neurological, renal, liver, and/or metabolic illness (e.g., diabetes mellitus) * Current, or history of uncontrolled, Stage 2 hypertension (blood pressure \>140 / 90 mmHg; anti-hypertensive medications are permitted) * Diagnosed obstructive sleep apnea * Previous bariatric surgery * Diagnosis or signs (e.g., values below the lower limit of normal) of overt airway disease(s) * Current or recent (regular use within the past 6 months) use of tobacco or nicotine products (e.g., cigarettes, vaping) * Pregnant (self-reported and confirmed via urine pregnancy test), lactating (self-reported), or post-menopausal (self-reported) females * Prisoners Per the POWERbreathe® company: * Patients who have undergone recent abdominal surgery and those with abdominal hernia. * Asthma patients who have a very low symptom perception and suffer from frequent, severe exacerbations or with an abnormally low perception of dyspnea. * If a patient is suffering from a ruptured eardrum or any other condition of the ear. * Patients with marked elevated left ventricular end-diastolic volume and pressure. * Patients with worsening heart failure signs and symptoms after training. If an individual is suffering from a cold, sinusitis or respiratory tract infection, it is advised that they do not use the POWERbreathe device.