Chronic treatment with compounds activating peroxisome proliferator-activated receptor (PPAR)␥ and -␣ influences body energy stores, but the underlying mechanisms are only partially known. In a chronic-dosing study, equiefficacious antihyperglycemic doses of the PPAR␥ agonist pioglitazone and PPAR␣/␥ dual activator ragaglitazar were administered to obesity-prone male rats. The PPAR␣ agonist fenofibrate had no effect on insulin sensitivity. Pioglitazone transiently increased and fenofibrate transiently decreased food intake, whereas ragaglitazar had no impact on feeding. As a result, body adiposity increased in pioglitazone-treated rats and decreased in fenofibrate-treated rats. PPAR␥ compounds markedly increased feed efficiency, whereas PPAR␣ agonist treatment decreased feed efficiency. In fenofibrate-treated rats, plasma acetoacetate was significantly elevated. Plasma levels of this potentially anorectic ketone body were unaffected in pioglitazoneand ragaglitazar-treated rats. High-fat feeding markedly increased visceral fat pads, and this was prevented by pioglitazone and ragaglitazar treatment. Pioglitazone treatment enlarged subcutaneous adiposity in high-fatfed rats. In conclusion, PPAR␥ activation increases both food intake and feed efficiency, resulting in net accumulation of subcutaneous body fat. The impact of PPAR␥ activation on feeding and feed efficiency appears to be partially independent because the PPAR␣ component of ragaglitazar completely counteracts the orexigenic actions of PPAR␥ activation without marked impact on feed efficiency. Diabetes 52:2249 -2259, 2003 T he nuclear receptors, peroxisome proliferatoractivated receptors (PPARs), constitute a family of three genes, PPAR␣, -␥, and -(␦), all of which are involved in control of energy homeostasis (1,2). Unequivocal evidence of endogenous ligands for PPAR␣ and -␥ is lacking, but a number of synthetic PPAR activating ligands exist, of which hypolipidemic fibric acids are typical examples of PPAR␣ activators while hypoglycemic thiazolidinediones are typical examples of PPAR␥ activators.The antidiabetic effects of PPAR␥ agonists are partly mediated via increased insulin sensitivity of adipose tissue and skeletal muscle. From clinical experience, PPAR␥ agonists are associated with weight gain, whereas PPAR␣ agonists appear body weight neutral (3). Part of the body weight increase may be caused by their oedema-inducing class effect, but activators of PPAR␥ also induce adipogenesis (4,5). They act preferentially on subcutaneous adipocytes, which in comparison to intrabdominal adipocytes express higher levels of PPAR␥ (6). The long-term metabolic consequences of the increased fat accumulation accompanying treatment with PPAR␥ agonists are not fully elucidated. Intrabdominal body fat accumulation is one of several hallmarks typifying the metabolic syndrome and, as such, an independent risk factor of type 2 diabetes (7-9). Many clinical trials of oral antidiabetic agents (including PPAR␥ agonists) are conspicuous by their absence of obese test subjec...