To investigate the relationship between weight deficit and depressive symptoms, 48 adolescent patients (41 females, 7 males) fulfilling DSM III R criteria for anorexia nervosa were also assessed for DSM III diagnosis of major depressive disorder (MDD). Patients who met diagnostic criteria for MDD had a significantly lower body weight than those without a current episode of MDD. In turn patients with high weight loss had higher mean depression scores (HAMD, SDS) than patients with less weight deficit. With increase of body weight we found a highly significant decrease of depressive symptoms. The authors hypothesize that the DSM III criteria for MDD may not specifically distinguish between starvation-related psychopathology in anorexia nervosa and primary affective disorder.