This phenomenological study investigated the perceptions of elementary principals regarding the need for a school-based student obesity prevention at eight, rural elementary schools in North Central Texas. Face to face interviews were the primary method of data collection from the eight participants. Findings indicated that school-based obesity prevention programs are needed to decrease the occurrence of student obesity, improve student diets and health related behaviors, educate families on obesity prevention measures, and improve the academic performance of students. The need to inform and include relevant stakeholders in the creation and implementation of school-based obesity prevention programs was identified as an essential component to the success of the program. The findings provide school leaders with components needed for an effective school-based obesity prevention program along with barriers for consideration.