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Background: Serum serotonin is synthesized and secreted mainly by enterochromaffin cells. However, most regulatory mechanisms underlying the metabolism of serum serotonin and its relationship with depression, dietary patterns and obesity are unknown. Methods: We studied 47 patients using Beck Depression Scale, a 24-hour food registry with analysis through DietBox®, biochemical tests, and serum serotonin levels by high-performance liquid chromatography (HPLC). Results: The mean body mass index (BMI) was 36.9±6.2 kg/m2. Depression was present in 34.0%. There were no significant differences in serum serotonin concentrations between patients with or without depression (156.4±63.5 vs. 147.7±71.2 ng/mL; P=0.357). The percentage of patients with abnormal serum serotonin concentrations and the presence of depression according to the degree of obesity were as follows: Class I 56.5% and 30.4%, Class II 54.5% and 36.5%, Class III 38.5% and 38.5%; P= .5 and P= .9, respectively. There were no significant correlations between serum serotonin concentrations and eating patterns related to calorie intake (r=0.09, P=0.54), carbohydrate (r=-0.03, P=0.81), fat (r=0.16, P=0.27), and protein (r=-0.24, P=0.09). Conclusion: We found that in adult women with obesity, there were no relationships between serum serotonin and nutrient intake, the presence of depression, or obesity severity.