Obesity and childhood overweight is a worldwide epidemic that has significant long-term public health implications both in developed and developing countries. South Africa, which has a well-documented burden of HIV/AIDS, tuberculosis, and other infectious diseases, now also has an increasing burden of obesity and noncommunicable diseases (NCD) such as diabetes and cardiovascular diseases. This article describes results of formative research on childhood obesity risk factors with parents of school-age children in the Western Cape region of South Africa. We interviewed parents living in low-income urban, rural, and township communities on nutrition and physical activity, media use, and potential social marketing messages. Study aims were threefold: to collect formative information on media use and health knowledge, attitudes, beliefs, and behaviors to support the development of an obesity prevention social marketing campaign targeting youth; to identify parents' preferred sources of health information, and to obtain reactions to potential obesity prevention social marketing messages. Overall, the family and community nutrition and physical activity environments in the Western Cape are highly complex. Parents report major safety concerns, lack of organized markets or other sources of healthy foods in rural and township areas, and lack of resources for physical activity. We also identified preferred sources for health information primarily through print and radio, obtained information about possible channels to reach parents, and identified potential message strategies to promote healthy lifestyles similar to some HIV/AIDS social marketing campaigns in Africa. This information supports future childhood obesity prevention social marketing.