It all began with Dexamethasone to get a curvy body, followed by weight-loss products to shed the extra kilos, and finally, body sculpting to achieve a whole new physique. It's a long journey, the story of a woman who subjected herself to all these standards, trying pills, syrups, and surgeries along the way.

The spring of 2020 was difficult for everyone with the spread of the COVID-19 pandemic, and Iraq was no exception. But for Duha, 42 years old, from Baghdad, the crisis was intensified by the discovery of a medium-sized tumour beneath her larynx, which soon spread to her back. 
Initially, doctors misdiagnosed her condition. But after selling her gold and everything she owned and didn’t own, her illness was finally identified. This marked the beginning of her treatment journey, made possible in part by her husband’s connections, which helped her access further tests and surgeries at private hospitals that still offer a lifeline to low- and middle-income patients. 

Duha’s treatment journey reopened the history of how she had interacted with her body. Shaping and reshaping it to meet the standards and expectations of each stage of her life. From making it fuller during her teenage years, to slimming it down, and later sculpting it. These were all transformations she imposed on herself. She now believes that this long pattern may have contributed to the thyroid cancer that eventually spread to other parts of her body. 
We’ll go back in time with Duha to trace this path, a path shared by thousands of Iraqi women who force harsh changes on their bodies to conform to the “ideal” image, often at the expense of their health, and without considering the emotional, physical, and financial toll. But how did it come to this? Why? And who bears the responsibility? 

Dexon: A food substitute during the sanctions 

Duha grew up in the Habibiya district in eastern Baghdad during the era of sanctions, a time when the dining tables of Iraq’s middle- and low-income families were restricted. The hardship reached the point of actual hunger for some segments of society, with the majority of Iraqis’ bodies showing signs of extreme thinness due to malnutrition. During that period, the average daily caloric intake per Iraqi dropped from 3,120 kilocalories before the sanctions to just 1,093 kilocalories during the peak of the sanctions in 1994 and 1995. 

Weight loss from the sanctions and hunger shaped self-perception. Duha Was No exception. The weight loss caused by the sanctions and hunger had a massive impact on how people perceived themselves, including Duha, the teenage girl who, from an early age, “resorted” to local medicines and treatments in an attempt to control her appearance and make her body and cheeks look fuller. 

“I wanted to be chubby. I dropped out of school because of how I looked, tall and skinny, like a stick, as the teacher used to say. I was really thin. They used to call me ‘the scrawny one.’ I admired how Inas Talib looked, and I tried to be like her. Back then, her cheeks were every girl’s dream. I weighed less than 50 kilos and needed a solution for how weak I looked. That’s when Dexon began to gain popularity among girls. Without my mother knowing, I started saving from my daily allowance to buy it.” 

At the time, the use of Dexon pills, without any medical supervision, became widespread in Iraq as a weight-gain and appetite-stimulating substance. These pills contain the active ingredient dexamethasone, a corticosteroid used to treat a range of medical conditions, including allergies, rheumatism, autoimmune diseases, and to relieve symptoms related to dermatological, respiratory, and allergic disorders. 

However, prolonged use of Dexon has several side effects, including muscle weakness, blurred vision, severe depression, high blood pressure, and irregular heartbeat. 

Weight gain, medically speaking, is considered one of the drug’s side effects. This is due to its role in causing fluid retention, increasing appetite, altering metabolic processes, and changing how the body stores fat, all of which collectively lead to increased body weight. 

The so-called magic drug initially appeared as a liquid in glass bottles and was commonly prescribed to children for allergic reactions. It was also available in tablet form before eventually being produced as capsules. 

Duha still vividly remembers the shape, smell, and taste of Dexon. 

“At first, it came as a syrup in a bottle, then later as capsules, I took both forms,” she said. The capsules resembled plaster in texture and smell, pink in colour, and came in a glass jar “with a yellow label and a yellow cap, marked ‘Dexon’.” Eventually, it began to be mixed with herbs and sold in local markets. 

Duha also clearly remembers why she started taking Dexon and how it affected her body at the time. 

“Honestly, just a few days after I started taking Dexon, my body became sluggish, and I lost all energy. I turned into someone who just ate and slept,” Duha recalled. She remembered days when she barely saw any daylight, and how her family had to increase her food portions to what would normally feed two or three people. 

“But then I started noticing the change, my body began to fill out, and so did my face.” 

Just a few months after her initial doses, Duha attended a social gathering where she felt she had become the centre of attention among relatives and guests. Her appearance had grown more “feminine and full,” as she described it. She added that she wasn’t overweight but had become attractive and eye-catching, especially in a time when weight gain was seen as a sign of prosperity and abundance during the sanctions. 

With Dexon, Duha compensated for the lack of fruits, sugars, and proteins in her diet, and she got what she wanted. She had reached what, in her eyes at the time, was the ideal body. So, she decided to begin tapering off the Dexon doses and, after about a year, stopped taking it entirely. 

When Duha stopped taking Dexon, her body gradually returned to its natural, slender frame. She noticed this early in 2003 and quickly went back to purchasing her magic substance. But the post-2003 period brought new products, many of which hadn’t been available before. “I bought pills, fattening medication, and appetite stimulants. After a while, I got my body back to where I wanted it,” she says. 

By mid-2004, Duha got married. At the time, she described herself as being at the height of her glow: “My cheeks were red, my body was full. Most girls back then were thin, so I stood out.” 

At her wedding, held in one of the narrow streets of eastern Baghdad, the young women sang in celebration: “Her cheeks like a tomato, don’t say she’s on Dexon!” This was one of the popular chants used by women at the time to praise a bride with plump, rosy cheeks, assuring the groom’s family that her full figure was a sign of well-being and prosperity, not the result of using Dexon. 

When beauty shifted from being thin to being fat 

In the decade following her marriage, with repeated pregnancies, childbirth, and the natural changes that come with age, Duha began to struggle with obesity. Her weight reached 102 kilograms. Over time, she began to lose the ability to walk long distances, despite being only 35 years old. 

“In 2016, I started to notice myself. I realised I was very overweight. That was when the internet started to spread, and suddenly beauty was about being thin, not fat anymore.” With shifting beauty standards favouring slimness, Duha tried to adapt to keep her body within socially accepted ideals. “Wherever I went, people would criticise me ‘Duha’s fat, Duha’s fat.’ I started having joint pain because of the weight, so I decided to lose it.” 

Toward the end of 2016, Duha began her reverse journey, this time, to lose weight. She started dieting and cutting down on food, a difficult shift after years of relying on Dexon. “I was used to eating a lot since the Dexon days. You can’t simply reduce your food intake overnight. I was used to a system. If I got hungry, I’d start crying.” 

Unable to maintain a healthy diet or reduce her daily meals, Duha once again resorted to slimming products. This time, to a dietary supplement called Lipo 6, or its updated version, Lypo 6, which is widely promoted as a powerful fat burner. She hoped to reverse the physical effects of the heavy Dexon use she had relied on in the late 1990s. 

Just like with Dexon, Duha took Lipo 6 without consulting a doctor and did not purchase it from a pharmacy. 
“If it’s trending, we buy it,” she said. 

She bought the slimming supplements from the same kinds of shops that had once sold her Dexon. Cosmetic stores in local markets. “From a shop that sells perfumes, creams, stuff like that,” she explained, where she would get the product in plain white containers, with no brand logo, usage instructions, or warnings about side effects. 

“Once I started taking slimming pills, I stopped feeling hungry, and my appetite dropped. They helped me lose weight, but still, I didn’t reach the shape I wanted,” she said. So Duha turned to a strict diet, which helped her shed about 15 kilograms in nine months. Still, she felt her features were too full. 

Due to social pressures and responsibilities, especially caring for her children, Duha couldn’t keep up the diet, and her weight crept back up to 100 kilograms. That’s when she made up her mind: “I need to end this and get rid of the weight,” she said. 

From a fixation on thinness to the operating room 

Duha and her husband were not financially well-off. Her husband worked as a serviceman in one of the military units, and his salary barely covered the household needs and the expenses for their five children for about twenty days each month. However, she described their situation as “just getting by,” which didn’t diminish her growing desire to undergo a gastric sleeve or liposuction procedure. Operations that had become increasingly common. 

“When I was younger, I learned sewing in a factory. And when I realised our situation wouldn’t allow me to save up for the surgery, I decided to buy a sewing machine. It would help around the house, and also help me save up for the operation, because there’s no way I could ask my husband for that kind of money. I’d feel ashamed even saying it. Like, how could I ignore my kids and their needs to focus on myself?” 

Duha began sewing at home after finishing her daily household chores. She also taught her eldest daughter sewing, and within six months, their reputation as skilled sewists had spread among their neighbours in the Al-Husseiniya district in northern Baghdad, as well as their extended family. “The small machine wasn’t cutting it anymore. I got an industrial one. Work was flowing, thank God.” 

Through this work, she was able to save enough money to fund the surgery. 

“I became obsessed with getting slim. It wore me out. I worked day and night to save for the surgery. It wasn’t even a matter of choice anymore. It was either I do it, or I do it.” 

At the start of 2019, Duha travelled with her daughter and husband to Beirut, having completed all the necessary procedures with the American University Hospital in the Lebanese capital. She described the day as “the happiest day of my life.” The trip would last around four weeks. 

The day after their arrival, she began her hospital consultations, met with the surgeon who would oversee the procedure, and underwent the required tests. 

“I was overjoyed. I weighed 97 kilograms at the time, and the doctor told me I’d reach 65 within two months. I was thrilled and full of hope. We agreed on everything, and my husband and daughter were with me. We went out, had fun, and a few days later, I had the surgery.” 

A few days after her consultation, Duha entered the operating room for a gastric sleeve procedure. 

During the nearly four-hour surgery, the doctor decided to remove about 75 per cent of her stomach. She stayed in the hospital for almost three weeks to recover, and then returned to Baghdad brimming with joy and pride in her new body. 

However, the surgery and the strict rest and dietary regimen it required kept her from returning to work. Her body needed around six months to stabilise fully. By then, Duha had achieved a sleek, modern figure that aligned with contemporary beauty trends. 

“For about six months, I stuck to the doctor’s dietary instructions, but honestly, I felt like something was wrong.” 

By the end of 2019, several months after the surgery, signs of fatigue began to appear on Duha. One day, while brushing her hair, she noticed a strand fall out between her fingers. When she examined her scalp more closely, she discovered bald spots she hadn’t seen before. 

“The doctor said it was due to vitamin and protein deficiencies caused by not eating enough. So, I started eating a bit more but still not normally.” 

But soon, Duha began to realise the problem was far more serious. She began to feel an unusual lump in her throat, and not long after, another appeared on her lower back. That was the beginning of her journey toward healing from tumours. 

Uncalculated risks… But why? 

Duha spent her life adapting to shifting beauty standards, striving to align herself with the trends, whether in an era that favoured thinness or one that celebrated fullness. She managed to present herself in ways that fit the expectations of each phase she lived through. But the journey from Dexon to crash diets was filled with danger, mainly because she took medications without medical supervision. 

Some doctors and pharmacists draw connections between certain types of cancers and the use of unregulated drugs and treatments. The unmonitored dosages and chemical compositions in these substances can lead to metabolic failure, thyroid dysfunction, and, in some cases, cancers, such as the glandular cancer Duha was later diagnosed with. While not a guaranteed outcome, this link is medically recognised and relatively common. 

Duha, like many women, has had a troubled relationship with her body. She never fully accepted herself, whether thin or full-figured. Her journey was one of constant intervention and alteration in pursuit of perfection as defined by ever-changing societal ideals. 

Reflecting on it now, she said, “I think the worst thing I ever did was not loving myself.” 

Perhaps the pressure, both real and online, drives some women toward harsh choices regarding their bodies. But for many, including Duha, it’s hard to pinpoint whether those choices were made to satisfy others and conform to social expectations, or if they were rooted in personal conviction. 

What Duha is certain of is this: she loves to see herself as beautiful. 

Now, after four years of battling illness, she often finds herself lost in thought, reflecting on her life. “Sometimes I think: I’m suffering now, who even cares if a body is thin or fat? Sometimes I’m harsh with myself, I say it’s my fault, maybe this is God’s punishment. And sometimes I tell myself: no, this is just my fate.”