OBJECTIVE-Melanocyte-stimulating hormone (MSH) peptides processed from proopiomelanocortin (POMC) regulate energy homeostasis by activating neuronal melanocortin receptor (MC-R) signaling. Agouti-related peptide (AgRP) is a naturally occurring MC-R antagonist but also displays inverse agonism at constitutively active melanocortin-4 receptor (MC4-R) expressed on transfected cells. We investigated whether AgRP functions similarly in vivo using mouse models that lack all neuronal MSH, thereby precluding competitive antagonism of MC-R by AgRP. RESEARCH DESIGN AND METHODS-Feeding and metabolic effects of the MC-R agonist melanotan II (MTII), AgRP, and ghrelin were investigated after intracerebroventricular injection in neural-specific POMC-deficient (Pomc Ϫ/Ϫ Tg/ϩ) and global POMC-deficient (Pomc Ϫ/Ϫ ) mice. Gene expression was quantified by RT-PCR. RESULTS-Hyperphagic POMC-deficient mice were more sensitive than wild-type mice to the anorectic effects of MTII. Hypothalamic melanocortin-3 (MC3)/4-R mRNAs in POMC-deficient mice were unchanged, suggesting increased receptor sensitivity as a possible mechanism for the heightened anorexia. AgRP reversed MTII-induced anorexia in both mutant strains, demonstrating its ability to antagonize MSH agonists at central MC3/4-R, but did not produce an acute orexigenic response by itself. The action of ghrelin was attenuated in Pomc Ϫ/Ϫ Tg/ϩ mice, suggesting decreased sensitivity to additional orexigenic signals. However, AgRP induced delayed and long-lasting modifications of energy balance in Pomc Ϫ/Ϫ Tg/ϩ, but not glucocorticoid-deficient Pomc Ϫ/Ϫ mice, by decreasing oxygen consumption, increasing the respiratory exchange ratio, and increasing food intake. CONCLUSIONS-These data demonstrate that AgRP can modulate energy balance via a mechanism independent of MSH and MC3/4-R competitive antagonism, consistent with either inverse agonist activity at MC-R or interaction with a distinct receptor. Diabetes 57:86-94, 2008 G enetic disruption of either mouse or human proopiomelanocortin (POMC) causes early-onset obesity (1-3), highlighting a major role of POMC in the regulation of energy homeostasis. POMC is processed posttranslationally into multiple peptides, including the opioid -endorphin and the melanocortins ACTH, ␣-melanocyte-stimulating hormone (␣MSH), MSH, and ␥MSH. POMC peptides in the central nervous system (CNS) are essential in the regulation of energy intake and expenditure as demonstrated in studies using compound mutant mice (Pomc Ϫ/Ϫ Tg/ϩ) expressing a Pomc transgene that selectively restored pituitary POMC in Pomc Ϫ/Ϫ mice to produce a neural-selective POMC deficiency (4). Lack of ␣MSH is likely the principal cause of obesity (3,5) due to the loss of agonist signaling at central melanocortin receptors (MC-R), melanocortin-3 receptor (MC3-R), and melanocortin-4 receptor (MC4-R), each of which plays a distinct role in the regulation of energy homeostasis (6 -8).The anorectic actions of centrally administered ␣MSH or the synthetic MC3/4-R agonist melanotan II (MTII) (9...