Mauritania must ban the practice of force feeding young girls to fatten them up for marriage, says a report which highlights the case of a child bride who died last year after being put on a dangerously high-calorie diet.
Some young girls in Mauritania are even taking animal growth hormones and other dangerous drugs to help pile on the pounds and make themselves more marriageable.
Many men in the West African country consider obese women beautiful, seeing their size as a sign of wealth and prestige.
Girls of around eight can weigh 140kg (300lb) after force feeding, putting a huge strain on their hearts and jeopardising their health. Young women can tip the scales at 200kg.
The practice is discussed in a new report on child marriage by rights group Equality Now which describes the case of Khadijetou Mint Moustapha whose weight ballooned after she was force fed from the age of seven. She was married at eight to her father's cousin, a man 10 years older than her father.
Khadijetou was seriously obese by the time of her wedding. After she fell pregnant her health rapidly deteriorated and her doctor put her on a strict diet to lose weight. She gave birth by cesarean section to save her baby's life.
But Khadijetou's mother, who prized her daughter's obesity, would not accept her weight loss and gave her a type of medication which she said women used to put on weight. The report did not identify the drug, but said its effect is to inflame and swell parts of the body.
Khadijetou's sight deteriorated and her doctor diagnosed eye strain, something she had been treated for before her wedding. Khadijetou was just 11 when she died last June, 20 days after giving birth.
Although it is a poor, drought-prone country about 20 percent of females in Mauritania are obese, compared to 4 percent of men, according to the World Health Organisation.
The practice of force feeding is known as gavage - the same French term used to describe the practice of fattening up geese to produce foie gras.
But women's rights organisations say they are increasingly seeing "chemical gavage" where girls take drugs including growth hormones, contraceptives and corticoids - steroid hormones - to bulk up. Health risks include heart failure, renal failure, diabetes, reproductive health problems, and joint pain.
In its report Equality Now calls for Mauritania to ban force feeding and child marriages, which account for over 35 percent of all marriages in the country, according to the U.N. Population Fund.
The report says gavage is closely linked to early childhood marriage because it accelerates puberty and makes younger girls appear more womanly.
L'Association des Femmes Chefs de Famille (AFCF), a local women's and children's rights organisation, is also calling for child marriage to be criminalised and is campaigning to get force feeding included as an offence under a new Bill on violence against women.
AFCF says it has seen an increase in the number of girls being fattened up and married off early, which it attributed to families facing increased financial difficulties.
The organisation has recently handled around 140 cases of child brides subjected to gavage, mostly chemical gavage. It tries to annul marriages, and encourage girls to lose weight, get medical attention and go back to school.
Activists point out that girls who take corticoids do not realise that the extra weight comes from water retention rather than fat, which is highly dangerous. Many girls and women also develop problems from fake drugs or expired black market drugs, AFCF says.