The purpose of this study was to describe how a child with obesity perceived participation in play activities. A single-case study design was chosen to optimize the understanding of the complexities of the research question. A 9-year-old boy diagnosed with obesity was studied. This is a typical case and is studied mainly to provide understanding to the issue. The data were collected from interviews with the boy, his mother and his teacher. Data were also collected through observations and a self-report assessment instrument called Kid Play Profile. The results showed that the boy was ridiculed by his peers and that at times he felt excluded from them, which prevented him from participating in play activities. The boy's experience came from different perceived problems such as lack of friends to play with, his inability to know how to perform in different play activities, and lack of proper support and encouragement from adults. Supporting children to overcome social skills deficits could prevent them from being teased and may have a positive effect on health. To optimize children's participation in play activities, it is important for adults to give them proper support and encouragement. The results were discussed with regard to earlier research, and topics for further research are suggested.