It's usually bad practice to compare a film to the book it's based upon but this is not a book I ever expected to reach the screen. After watching, my first instinct was correct.
Victor (Sam Rockwell) is a sex addict. He attends meetings because it's easy to hookup and it's where he met his best friend, Denny (Brad William Henke). They grudgingly work at a colonial theme park. Victor dropped out of med school to finance his mother's (Anjelica Huston) elder care even though she didn't do a great job raising him. To make up the difference between his salary and the hospital payment, Victor chokes on food in nice restaurants where people “save” him and feel forever responsible, sending him monetary help. As his mother's condition worsens, a young doctor (Kelly Macdonald) offers her help through an untraditional treatment.
Chuck Palahniuk's novel is perverse and intriguing. While Clark Gregg's script hits the major beats of the original narrative, it misses the purpose of Victor's connection to Jesus; coincidentally making him appear more freakish than he really is. Palahniuk's stories are very internal, relying heavily on personal narrative. Fight Club was a successful adaptation because it understood that; Choke attempts to tell the story almost entirely through visuals, which loses the essence of the original as well as Victor's personality.
The first act of the film remains loyal to the source and is consequently fascinating, but as it continues and strays further from the original it also becomes somewhat boring. Furthermore, the endings differ greatly. The film's conclusion misses the quirkiness of the book's, opting for a more traditional Hollywood ending.
Fortunately, Rockwell is the perfect embodiment of Victor. He fits the physical description and projects all of the intricacies of his personality. The supporting cast is also proficient but the film would not work at all if Rockwell's performance was not spot on.