Dear Editor,

It is widely known that limb amputation represents one of the oldest and most serious surgical operations [1]. There have been various reasons cited for the execution of limb amputation over the centuries (such as traumatic injuries, infections, gangrene, punishment for people who committed crimes, vascular disorders, diabetes mellitus, and malignancies). However, an association between limb amputation and compulsive overeating behavior is described, to my knowledge, for the first time in the Christian Patristic Tradition. To be more specific, in his ascetical treatise for monasticism, Ladder of Divine Ascent (Greek: Κλίμαξ; Latin: Scala Paradisi), Saint John Climacus, also known as John Sinaites (c. 579–649 AD), clearly outlines the psychosomatic passion (“addiction”) of binge eating (Greek: γαστριμαργία) as a “hypocrisy of the stomach, for when it is saturated it complains of scarcity, and when it is loaded and bursting it cries out that it is hungry” [2]. In the same text, the author highlights that “some who were servants of their stomach have cut their members right off, and died a double death” [2]. It is quite evident that by “cut their member right off,” Saint John Climacus must be referring to limb amputations performed on overeaters who were also, most likely, obese diabetic patients with peripheral neuropathy and micro-macroangiopathy. Furthermore, the double death represents the death of the person’s soul and body.