purportedly all three of these incidents are based on true stories. according to palahniuk, the first two tales came from his friends' experiences and the third he heard while shadowing sexual addiction support groups as research for "choke". in one of these groups, he met an extremely thin man. when palahniuk asked him how he stayed so thin, he told him "i had a massive bowel resectioning." when palahniuk asked what he meant, he told him the story which was the basis for the third episode in "guts".