Force-Feeding and Drug Abuse: The Steep Price of Beauty in Mauritania

Force-Feeding and Drug Abuse: The Steep Price of Beauty in Mauritania

. 10 min read
“It’s for their own good…How will these poor girls find a husband if they’re bony and revolting?”

Elhacen, who force-feeds young girls for a living, takes pride in her work. “I’m very strict…I beat the girls, or torture them by squeezing a stick between their toes. I isolate them and tell them that thin women are inferior,” she says. This child cruelty is the horrific product of Mauritanian beauty standards, which idealize obese bodies. According to Elhacen, a woman’s job is “to make babies and be a soft, fleshy bed for her husband to lie on.” The force feeder even enjoys additional payments for stretch marks, hailed as a crowning achievement for any Mauritanian woman trying to gain weight.

This force-feeding practice is called “leblouh” or “gavage,” a French term that refers to “the process of fattening up geese to produce foie gras.” This dehumanization of girls and women extends far beyond semantics. Historically, Mauritania’s Moor population, which makes up two thirds of the country’s 3.1 million people, has viewed female obesity as a status symbol, with thinness being a sign that a woman’s husband could not afford to feed her. As a result, in order to display wealth, higher-income girls were fattened with milk to make them more desirable to potential suitors. Exemplifying this relationship between obesity and attractiveness, a Moor proverb asserts that “the woman occupies in her man’s heart the space she occupies in his bed.” By creating a direct relationship between weight and desirability, this beauty standard encourages extreme behavior.

Force-Feeding and Early Marriage of Young Girls

This extremity is evident in the abuse of young girls at the hands of force-feeders like Elhacen. Girls as young as five are sent to “fattening farms” to gorge on calorie-dense foods such as millet and camel milk. Force-feeding can also occur at home, often supervised by a girl’s mother. Activist Lemrabott Brahim describes how this mother-daughter dynamic perpetuates leblouh, explaining that the practice is “deeply-rooted in the minds and hearts of Mauritanian mothers, particularly in the remote areas.” Disciplined by their mothers or force-feeders, girls may be force-fed up to 16,000 calories daily, which can include up to five gallons of milk. Older female force-feeders or relatives who conduct the leblouh employ brutal tactics to keep their girls eating. For example, the “zayar” technique involves positioning a girl’s toe between two sticks and pinching it when she resists leblouh. The supervisor may also “pull her ear, pinch her inner thigh, bend her finger backward or force her to drink her own vomit,” and girls are further threatened with beatings if they do not finish their food. A 2013 study using survey data from 2000 found that “over 61% of those who had experienced gavage reported being beaten during the process and almost one-third (29%) reported having their fingers broken to encourage participation." In addition to these excruciating injuries, Mar Jubero Capdeferro of the U.N. Population Fund notes that leblouh is increasingly dangerous because some force-feeders have transitioned from using camel’s milk to force-feeding young girls “with chemicals used to fatten animals.”

In a 2018 Unreported World documentary, reporter Sahar Zand witnessed this cruelty firsthand, interacting with Mauritanian women to learn more about leblouh. She describes how girls are fattened during the rainy season, when food is more plentiful, gaining a targeted seven kilograms. According to Zand, about 25 percent of Mauritanian women endure leblouh, but the percentage could be as high as 75 percent in rural communities where women are especially vulnerable “because there are no distractions and no easy ways to escape.” Zand focuses on one particular group of rural nomads with two young girls undergoing leblouh. It takes them each two hours to finish a 3,000-calorie breakfast, followed by a 4,000-calorie lunch and a 2,000-calorie dinner. By the end of the feeding season, the girls will consume 16,000 calories every day. Zand tried the leblouh diet—after lunch, she could not continue, but the little girls were forced to keep eating. “It’s horrible,” she describes. A force feeder claimed that pushing her daughter through leblouh is an act of love. Trying to explain how mothers could inflict such “pain and torture” on their own daughters, Zand concludes: “This is a society where a woman’s biggest power is to be beautiful, and to be beautiful, you have to be fat.”

Zand could have easily re-phrased this statement as: “This is a society where a woman’s biggest power is to marry, and to marry, you have to be fat.” The 2013 study breaks down the centrality of child marriage to leblouh, for “the large size of these force-fed girls creates an illusion that they are physically mature and ready for marriage.” In creating this illusion, leblouh suppresses the marrying age of girls, perpetuating a child marriage crisis. Legally, Mauritanian women must be 18 years old to marry, but de facto, younger brides are common; a 2015 study concluded that “nearly one out of three girls aged between 15 and 19 gets married.” According to 2019 data, 37 percent of Mauritanian girls marry before age 18. Often, these young girls marry older men. One 29-year-old victim of child marriage began leblouh at age four, married at 12, and got pregnant at 13 “right after [her] first period.” These child marriages and pregnancies severely jeopardize the physical and mental health of the female Mauritanian population.

Long-Term Health Consequences of Leblouh

Even after marriage, women continue to suffer from extreme beauty expectations. Dr. Mohammed Ould Madene recalled a patient: “She was only 14, but so huge that her heart almost collapsed under the strain.” He worries about women’s risk of weight-related health problems such as diabetes and heart disease. Other long-term effects of obesity include hypertension, high cholesterol, stroke, osteoarthritis, poor mental health, decreased mobility, sleep apnea, and cancer. Due to leblouh, these national health concerns disproportionately impact women: as of 2016, 18.5 percent of Mauritanian women were obese, compared to only 6.6 percent of men.

These statistics are particularly alarming in the context of a global pandemic, for which obese individuals have higher “risks of hospitalization, intensive care unit admission admission, invasive mechanical ventilation, and death” from COVID-19. Considering barriers to healthcare access in Mauritania (the country has only 0.18 physicians for every 1000 citizens, compared to 2.59 physicians in the United States), obese Mauritanian adults are especially vulnerable to complications from the coronavirus. This additional risk underscores the fact that exacting beauty standards are severely limiting women’s health and lifestyle opportunities. One 26-year-old woman describes this dilemma: “I’m always tired, and I wheeze when I walk. I want to be slimmer so I can be more dynamic…I’d love to be able to wear jeans and high heels. I want to diet, but I’m scared men won’t like me anymore.” Her words exemplify the extreme pressures on women to sacrifice their mental and physical health to appease the male gaze, a practice especially detrimental during the COVID-19 crisis.

Medication Abuse and Black Market Drugs

However, obesity is not the only threat, for many women abuse medications and take black market drugs to become obese more quickly. These drugs include birth control, cortisone, and even livestock medications, such as “hormones used to fatten camels and chickens.” One 26-year-old woman, whose husband reportedly “didn’t like sleeping with a bag of bones,” has resorted to allergy drugs that peripherally boost weight gain at the risk of other complications. “I bought this one because the pharmacist told me it was the least dangerous,” she explained. These drugs are easy to purchase and not heavily regulated, which can—according to one pharmacist—be partially attributed to the profitability of black market drug sales to an eager female market. When Sahar Zand visited the Mauritanian capital, Nouakchott, she noted the openness and conspicuousness of these drug sales, remarking, “That was too easy. They weren’t even trying to hide it.” Such markets teem with feeders buying drugs for their girls and older women buying for themselves. Zand even met a family whose daughter died from taking weight-gain steroids, yet another daughter continues to take the same steroid. Dr. Madene’s words effectively summarize the crisis: Mauritania’s beauty standards are “a grave matter of public health.”

Backsliding After the 2008 Military Coup

Recent political events offer some insight into this crisis. By 2007, the obesity obsession appeared to be improving—the Mauritanian government was trying to bolster national public health and raise awareness surrounding the dangers of obesity. The New York Times even joked: “Until lately, a Mauritanian woman in jogging shoes was about as common as a camel in stiletto heels.” Beauty standards were evolving, and increasingly health-conscious. However, the murder of French tourists by al-Qaeda in 2007 resulted in fewer foreign visitors to Mauritania, and after a military coup in 2008 that ousted the democratic regime, the incoming junta began to revive traditional values under the leadership of General Mohamed Ould Abdelaziz. Aminetou Moctar, leader of the activist group Women Heads of Households, bitterly remarked, “The authorities want women to return to their traditional roles—cooking, staying indoors, and staying fat to keep men happy.” Aminetou Mint Ely, a member of the same organization, expressed similar sentiments:

"We have gone backwards. We had a Ministry of Women's Affairs. We had achieved a parliamentary quota of 20 percent of seats. We had female diplomats and governors. The military [has] set us back by decades, sending us back to our traditional roles. We no longer even have a ministry to talk to."

The government’s unraveling of cultural progress helps explain why Mauritanian law still fails to hold the perpetrators of leblouh accountable. Fatimata M’baye, a lawyer for children’s rights, laments: “I have never managed to bring a case in [defense] of a force-fed child. The politicians are scared of questioning their own traditions.” Therefore, the government actively perpetuates the brutal subjection of girls to leblouh, child marriages, and continuous pressures to fatten themselves.

Paths for Progress

However, amidst this regression, there is hope for progress. The success of pre-coup awareness campaigns indicates that Mauritanian women are open to prioritizing health and loosening the hold of beauty standards. After the government began to educate citizens about ethical treatment of children and physical health in 2003, rates of leblouh began to decline. Kajwan Zuhour, who worked in a female-only gym in Nouakchott, noticed more and more customers by 2009: “Women don't want to be fat anymore, they want to be thin,” she said. This changed outlook emerged from the work of women like Yeserha Mint Mohamed Mahmoud, who was involved in government information programs. She described how many women were unaware of leblouh’s extreme health risks: “The diet here is very rich—they eat couscous, pure lard…[and] don't know this food is fattening, so we explain to the women what to eat every day, so they don't put on weight and they can protect themselves from diseases.'' This observation indicates that future information campaigns must be multifaceted to cover various demographics; some women deliberately feed themselves—and force-feed young girls—fattening food to gain weight, while other women unknowingly consume similar foods. Perhaps, this difference can be partially explained by an urban-rural divide, in which rural women are more familiar with leblouh and the foods most conducive to weight gain. Although this variation underscores the need for additional specialized information campaigns, sweeping, nation-wide efforts to boost awareness of leblouh’s adverse health effects are still worthwhile. Aminetou Mint Ely of the Association of Women Heads of Households remarked that “the government even commissioned ballads condemning fattening,” demonstrating the creative extent of its efforts.

Since the new military junta began dismantling and reversing these governmental programs, the role of private sector organizations has become increasingly important. For example, May Mint Haidy founded an NGO to promote healthier habits among Mauritanian women: “We have carried out a campaign to convince these women to give up the habit of forced feeding. The reason we as an NGO are trying to spread the message is because this forced feeding can lead to dangerous diseases like heart attacks, blood diseases.” These messages are important to ensure adult women do not jeopardize their own health or that of their young daughters. With this mission in mind, NGOs can revive and build upon the work of prior governmental campaigns, counteracting traditional rhetoric glorifying obesity. They should also work to “empower women economically and politically, especially in rural areas, and…reduce illiteracy,” which would further promote physical and mental health. The primary motivations for leblouh and the consumption of weight-gain drugs are early marriage and male validation. If women feel secure and capable in their own right, they would be less likely to sacrifice their health for others. Empowerment and improved literacy would also battle child marriage, arm women against misogynistic government rhetoric, enable them to pursue careers, and help them not only avoid self-destructive practices, but actively take charge of their well-being.

In order to ensure that such efforts reach women in rural areas—a problem noted by Aminetou Mint Ely, May Mint Haidy, and Yeserha Mint Mohamed Mahmoud—larger NGOs will likely need to partner with local community groups and “traditional information sources.” Immediately before the coup in 2007, Haidy told the New York Times that only about 25 percent of Mauritanian women watched TV and even fewer tuned into radio programs; since this statistic aggregated all women across the country, it suggests that the rate of media consumption is even lower for women in rural areas. Given these limitations, NGOs should also consider forging connections with religious leaders, expanding the role of mosques to encompass both worship and education.

After all, many imams have already demonstrated their commitment to uplifting women and children through existing media channels. For example, the Sahel Women’s Empowerment and Demographic Dividend project (SWEDD)—which spans multiple African nations including Mauritania, Mali, and Niger—combats child marriage and uplifts women through radio. If imams involved in such efforts could spread these positive messages to rural mosques, ideally partnering with local religious leaders, women without access to radio could be empowered as well. Hademine Saleck Ely, an imam in the Mauritanian capital of Nouakchott and a member of SWEDD, powerfully articulates Islam’s moral repudiation of practices that harm women: “Islam is a religion that honours human beings. Any action that harms an individual's physical or mental health is therefore forbidden.” Given this support, local community religious leaders may be critical in the fight to ensure messages about the dangers of leblouh reach women across Mauritania.

Mauritania’s beauty standards—manifesting in the force-feeding of young girls, child marriage, and the abuse of weight gain medications—are centuries-old. However, they are not immune to change. Information campaigns about healthy habits, the many dangers of force-feeding, and child advocacy are promising avenues for progress, especially with the assistance of religious leaders to spread positive messages in rural areas. Additional initiatives to empower women and increase literacy would help dismantle patriarchal gender relations and foster female independence. The tenacious advocacy of women such as Aminetou Mint Ely and May Mint Haidy prove that such solutions are entirely possible. With their help, the health and beauty of Mauritanian women can cease to be mutually exclusive.