Laborer, 20, has two healthy fingers amputated to treat his ‘body dysmorphia’

A man in Canada has had two of his fingers amputated to cure his body dysmorphia.

The unnamed patient, 20, said that ever since childhood he had ‘incessant,’ intrusive thoughts about the fourth and fifth fingers on his left hand. 

His doctors at Université Laval in Quebec wrote that while he understood that the fingers were his own, he felt ‘they should not belong to his body.’ 

The sawmill worker was plagued with nightmares of the digits burning or rotting, and he even considered building a small, makeshift guillotine because ‘he couldn’t imagine himself living for the years to come with those fingers.’ 

The medical team said that the patient was pursuing surgical amputation because he would otherwise do it on his own, ‘aiming to alleviate his intense suffering.’

However, after doctors removed both fingers, the man’s emotional distress immediately dissipated. 

Doctors diagnosed him with body integrity identity disorder (BIID), a rare form of body dysmorphia that causes patients to want to have at least one healthy limb amputated or become paralyzed. 

BIID can affect any part of the body, including legs, arms, fingers, toes, eyes, ears, and teeth. 

A 2023 study in the journal Healthcare found that most patients opt to remove their left leg. Some participants said they chose left over right because they needed their right leg to drive.  

Just 200 cases have been reported in medical literature so far, and experts are still working to find the cause of the bizarre condition. However, it’s believed to be driven by a mismatch between someone’s mental image of their body and their actual appearance.

A 2020 study in the journal Cell, for example, recruited 16 men who wants to remove their healthy left legs from an online support group, 

The team found that those with BIID had noticeable changes in their brain structure, such as the paracentral lobule, which controls how we feel and interpret feedback from the lower limbs. 

These patients had reduced connectivity between the paracentral lobule and others areas of their brains. 

Additionally, the right superior parietal lobule, which is responsible for someone’s total body image, had reduced connectivity and lower gray matter density. Gray matter is needed to help regulate emotions. 

The researchers in the case report said that distress caused by BIID could lead patients to ‘attempt self-amputation, risking their lives.’  

‘The limited literature on this condition poses challenges in establishing clear guidelines and recommendations,’ the team wrote.

‘Patients often hesitate to seek help from healthcare professionals, turning to internet forums for advice, complicating the assessment of BID’s actual prevalence.’

‘Nevertheless, surgery as a treatment option for this lesser-known disorder should be carefully considered.’

According to Cleveland Clinic, patients engaging in ‘self-harm’ by amputating their own limbs can suffer uncontrolled bleeding, infection, nerve damage, severe pain, and phantom limb pain – the perception of pain or discomfort in a limb that is no longer there. 

Though many patients choose to keep their symptoms secret, others have spoken out about their intense desire to amputate their own limbs.

Robert Vickers of Australia, for example, told the Australian Broadcast Corporation (ABC) that from the time he was just 10 years old, he felt his left leg below the knee didn’t belong with the rest of his body.

This led him to twice use dry ice to damage his leg, though neither attempt worked.

‘I’d appreciate it if a surgeon or hospital in the Sydney area could come forward and potentially offer me their services,’ he said. It’s unclear if any doctors eventually followed through. 

The case study was published in the journal Clinical Case Reports.