BackgroundEarly-life adversity that increases the risk of growth stunting is hypothesized to increase the risk of obesity and, in girls, early-onset puberty. This hypothesis was tested in children adopted from orphanages.MethodsPost-institutionalized (PI) youth were compared with youth reared in comparable families (non-adopted; NA) on height, weight, pubertal stage, and fat mass (127 PI, 80 female; 156 NA, 85 female, aged 7-14 years). Anthropometric findings at adoption were obtained from first US clinic visits.ResultsOverall, 25% of PI youth were height-stunted (<3rd percentile) at adoption. Years post adoption, PI youth had lower BMI-for-age (P=0.004), height-for-age (P<0.001), and less body fat (P<0.001) than NA youth had, but they did not differ by sex. Pubertal status did not differ by group or sex. The anthropometric findings held when the stunted-at-adoption subset was examined; they were also less likely to be in central puberty than other PI youth.ConclusionEarly deprived orphanage care increases the risk of growth stunting but not obesity in children adopted into US families, and it does not independently contribute to early-onset puberty for PI girls. The role of the environment following early adversity may modify the impact of early adverse care.