Lesions of the ventromedial hypothalamus (VMH) result in obesity and enhanced cellular proliferation in various organs, including the pancreas, gastrointestinal tract, and liver. Previous studies have suggested that vagal hyperactivity, rather than overeating, induces the peripheral cell proliferation in VMH-lesioned rats. The goal of the present study was to investigate the mechanism of peripheral cell proliferation in VMH-lesion-induced obesity by infusing rats with the acetylcholine agonist, carbachol, and then measuring cellular proliferation in the pancreas and duodenum using immunohistochemistry. The ventromedial hypothalamus was bilaterally lesioned in five rats. In other rats, the bilateral vagus nerves were ligated (vagatomized), and saline or carbachol was continuously administered by an osmotic minipump (n = 5 in each group). Three days later, rats were killed, and cell proliferation was assessed in the pancreas and the duodenum using immunohistochemistry for proliferating cell nuclear antigen (PCNA). Additionally, cellular proliferation in the duodenum was more precisely examined by assessing incorporation of 5-bromo-2'-deoxyuridine (BrdU). Cellular proliferation was higher in rats that received carbachol infusions and in rats with VMH-lesions when compared with control rats (P < 0.05, respectively). The pancreatic PCNAexpressing cells were predominantly identified as the B-cells of the islets of Langerhans. These data demonstrate that carbachol infusion can induce pancreatic and duodenal cell proliferation to a degree that was comparable to that in vagal hyperactivity induced by VMH lesions.The ventromedial hypothalamus (VMH) mediates important neural pathways for feeding behavior in various animals, including cats, mice, rats, and humans (1,3,13,22,40). Lesions of the VMH result in a metabolic obesity syndrome of endogenous hyperinsulinemia, insulin resistance, low sympathetic activity, and high parasympathetic tone (18,25,53) that is mediated by various factors, including neuropeptide Y (14, 43), orexins (19), ghrelin (9, 51), melanin-concentrating hormone (5,11,15,36,39), neuromedin U (21), leptin (4, 17, 42, 48), melanocortin (20), corticotropin-releasing hormone (44, 46, 47), and brain-derived neurotrophic factor (27,45,52). Nevertheless, the relationship between these central mediators and obesity remains unclear.One study reported that lesions of the VMH also result in an increase in DNA synthesis in digestive organs (29,31). Interestingly, VMH-lesion-induced obesity in rats can be prevented by vagotomy (7,8,23), and bilateral vagotomy or infusion of atropine