While Tappy Tibbons mentions several times that there are three steps to his program, only two steps are ever mentioned in the film; Tappy tells his audience to avoid red meat and to avoid sugar, but Sara is always prevented from hearing the third step. Director Darren Aronofsky had intended the third step to be the removal of pharmaceuticals from the equation. The film's producers asked Aronofsky to change the third step because they were concerned that pharmaceutical companies would feel that the film's message was targeting them or encouraging people to avoid taking medication. The third step was changed to "no orgasms" and filmed as such, but Aronofsky edited the footage so that Sara would either start to daydream or feel the effects of the drugs and be unable to hear the third step. It can however still be briefly seen in the final film, written on Tappy's whiteboard at 10m18s and 36m14s, and is also included in full as supplementary material on some releases.

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