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Pica Eating Disorder A–Z: Symptoms, Causes, and Effective Treatment

Imagine having an overwhelming urge to eat something that’s definitely not food. That’s precisely what people with the eating disorder pica have. People diagnosed with pica often want to eat things like dirt, soap, mud, hair, and more. Keep reading for information on pica syndrome, its causes, and treatment options. 

Pica is defined as a compulsive eating disorder that causes people to eat items that are not typically considered food and don’t provide nutritional value. Some examples include:

  • Dirt
  • Gum
  • Soil
  • Paint
  • Laundry starch
  • Paper
  • Pottery
  • Mud
  • Clay
  • Charcoal
  • Ash
  • Coal
  • Sand
  • Soap
  • Glue
  • Wool
  • Carpet
  • Metal
  • Plastic
  • Tissues
  • Wood
  • Hair

An individual who consumes food starches in their uncooked form (such as uncooked pasta, rice, or flour) doesn’t meet the criteria for a pica diagnosis. This is because a person with pica eats items that hold absolutely no nutritional value, and uncooked starches do have some nutrients. 

Young children often put nonedible items in their mouths because they’re curious about the world. Pica in children, however, goes beyond curiosity. It’s usually a constant desire to eat items that aren’t food. If left unaddressed, it may lead to serious health problems. 

Pica got its name from the Latin word for a type of bird called the magpie. This bird eats almost anything, making it similar to people suffering from this particular eating disorder. 

To be diagnosed with pica, several criteria should be met according to the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5):

  • Repeated eating of nonfood substances for at least one month.
  • This eating behavior is inappropriate to the patient’s developmental level, and is not part of a person’s culture.

The prevalence of pica is not known, but it may be greater in patients with intellectual disability. Onset of this eating disorder most often occurs during childhood, but it can occur during adolescence or adulthood.

Pica eating disorder is a compulsive disorder, meaning people cannot stop their actions. 

Some common signs of pica disorder are:

  • The frequent eating, for one month or longer, of substances that are not thought of as food and that don’t provide nutritional value.
  • The chosen substances are not associated with culturally or socially supported practices. For example, some cultures encourage eating clay for medicinal purposes.
  • Frequent stomach issues occur, such as an upset stomach, stomach pain, blood in the stool, and bowel problems. 
  • The person cannot stop even after being confronted. 

Pica can affect children and adults of both genders. Doctors are unsure of what causes pica, but some people are more prone to the disease, including:

  • Individuals with developmental conditions, such as autism or intellectual disabilities — approximately 10–15 percent of people with developmental issues have pica. 
  • Children under the age of 2 years often put objects and substances in their mouth. If the habit continues past the age of 2, it could be a sign of pica. 
  • Individuals with other mental health conditions, such as schizophrenia and obsessive-compulsive disorder (OCD), are at a higher risk of developing pica. 
  • Individuals who are suffering from extreme hunger or malnutrition may turn to nonfood items to feel full. 
  • Low levels of iron or zinc can trigger specific pica-related cravings. This is a sign of the body attempting to resolve a serious nutrient deficiency. As the prevalence of pica is so significant in individuals suffering from an iron deficiency (anemia), some scientists believe that pica is the body’s attempt to ingest minerals. 
  • There seems to be a link between stress and pica. Children living in poverty and children who have been abused or neglected have higher instances of pica. 
  • Sometimes pregnant people will find themselves craving strange, nonfood substances. Typically, they find themselves craving dirt or clay. This is actually a sign of an iron and zinc deficiency. If pica develops, it usually happens in the first trimester of pregnancy. 
  • Dieting and orthorexia nervosa. What is orthorexia? Orthorexia is an avoidant restrictive food intake disorder. A person becomes obsessed with healthy eating to an extreme. At times, this can result in feeling empty and hungry all the time. When this occurs, individuals can develop pica out of a desire to feel full. There are reports of models doing this. 
  • Scientists have established a link between pica and decreased dopamine activity. Dopamine is a neurotransmitter that sends nerve impulses from one cell to another. Some researchers suggest that abnormally low levels of dopamine in the brain can result in pica.

Patients with a pica eating disorder should always seek treatment. If left untreated, pica may lead to health complications. Typically, the first step in treatment is testing for a nutrient or mineral deficiency and correcting it. Doctors may check for anemia or zinc deficiencies, test the level of lead in the blood, conduct stool tests to check for parasites, and order X-rays to look for bowel blockages. 

However, correcting a deficiency won’t typically result in corrected behavior. If the pica tendencies continue after a deficiency correction, the individual should seek counseling. 

For children with autism and pica, there are some intervention techniques. Some techniques include distracting the patient’s attention away from the desired substance and rewarding them for discarding it. For pregnant people, pica often stops spontaneously or after nutritional issues are addressed. 

If you believe your pica is due to stress or anxiety, stress management techniques can help reduce the urges associated with pica.

Depending on what nonfood substances individuals with pica choose to eat, they could be ingesting toxic chemicals, poisons, and bacteria. The consumption of nonedible objects can also cause serious issues such as: 

  • Constipation
  • Diarrhea
  • Ulcers
  • Intestinal tearing
  • Tearing in the esophagus
  • Lead poisoning
  • Bacterial infection
  • Gastric pain and bleeding
  • Damage to teeth
  • Bowel blockages

The toxic chemicals in some substances, such as paint chips, can particularly be damaging for children or pregnant people. Poisons and toxic chemicals can result in learning disabilities and brain damage. Additionally, bacteria can lead to severe infections that can result in kidney damage. 

Pregnant women, in particular, could be putting their baby at risk with a pica disorder. Harmful substances can be passed from the nonfood to the mother and her fetus. Additionally, pica can interfere with the absorption of nutrients in healthy food, resulting in a nutritional deficiency. If the mother always fills up on food with no nutritional value and has no appetite left for real food, the fetus won’t receive the proper nutrients it needs for development and growth. 

If you have pica, the first step is to see a doctor who can help you address nutritional deficiencies.

Once your dietary deficiencies have been addressed, you can choose to focus on any outstanding behavioral issues. A psychologist or psychiatrist may be able to help. Don’t assume you can address pica on your own. It’s a compulsive disorder that may require extensive psychotherapy that addresses why your pica condition began. Psychotherapy will also teach you tactics so you can actively avoid relapsing back into dangerous behaviors. 

Co-existing mental health or development issues can make treatment of pica more difficult. In these scenarios, it’s likely better to seek the help of a specialist. 

Pica may lead to serious health complications if not addressed. Fortunately, with nutritional tests and counseling (for some), it’s a condition that may be overcome.