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The inspiration for the film's plot came from a joke that writer/director Tom Six once made to his friends about punishing a child molester they saw on TV by stitching his mouth to the anus of an overweight truck driver. Six saw this as the concept for a great horror film, and he began to develop the idea. He has said he was heavily influenced as a filmmaker by the early works of David Cronenberg and Japanese horror films. Six has said he prefers horror films that are more realistic over "unbelievable" monster films, and that he gets "a rash from too much political correctness. " A major influence for The Human Centipede was Pier Paolo Pasolini's controversial 1975 Italian drama film Salò, or the 120 Days of Sodom, which was notable for its scenes depicting intensely graphic violence, sadism, and sexual depravity, as was the work of Japanese director Takashi Miike. Six has also expressed his love of the works of David Lynch. Further inspiration came from Six's previous role as a director on the Dutch series of Big Brother, where he had been able to observe people who "did crazy things when they were alone and thought they were not (being) watched. "