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What is Pica?
Pica is an eating disorder that causes people to compulsively eat items that are not considered food or items that have no nutritional value. An eating disorder is considered a mental health condition that causes individuals to have an unhealthy relationship with food.
Thus, pica is both a medical condition and pica is a psychological disorder.
Pica conditions can affect anyone of any age, race or gender. It often occurs along with other mental health disorders including intellectual disabilities, autism spectrum disorder, schizophrenia, trichotillomania, excoriation disorder, obsessive compulsive disorder and sickle cell disease.
A study published in 2022 found that pica disorder may also be associated with depression, anxiety, poor body image and other eating disorders.
Additionally, pica eating disorder is sometimes seen in people with iron deficiency anemia, malnutrition, or a family history of pica during pregnancy.
People living in developing countries appear to have higher incidences of pica when compared with more industrialized nations.
This likely occurs as a result of the food insecurity and malnutrition seen in those nations. It’s unclear how many people are impacted by pica sickness because research on the condition is scarce.
Signs and Symptoms of Pica
A diagnosis of pica is made when an individual exhibits a pattern of eating nonfood substances for at least one month. Symptoms of pica are generally a result of eating nonfood items.
Persons with pica may develop roundworm infection, constipation, electrolyte imbalances, heart arrhythmias, lead poisoning and intestinal obstruction.
Common non-food items eaten by persons with pica:
- Ash
- Baby powder or talcum powder
- Chalk
- Charcoal
- Clay, dirt or soil
- Eggshells
- Feces of any type
- Hair, string or thread
- Ice
- Laundry detergent
- Paint chips
- Paper
- Pebbles
- Pet food
- Soap
- Wool or cloth
FAQs
What Causes Pica?
Researchers are unclear on the exact cause of pica sickness but have recognized relevant components that increase the risk of developing the disorder. These include:
Cultural or learned behaviors
Pica may originate from learned behaviors, including cultural or religious practices that involve the consumption of nonfood items during certain rituals. However, pica is diagnosed only when these behaviors transcend cultural or religious practice and become a compulsive behavior that puts the individual’s physical, emotional, or mental health at risk.
Stress or anxiety
For certain individuals eating nonfood items is a coping mechanism.
Adverse childhood experiences/childhood food insecurity
Poverty may induce some people to consume nonfood items, although the exact reasoning for this is unknown. Researchers hypothesize that this may be a coping mechanism or attention seeking behavior in children and adults who have experienced food insecurity.
Nutritional deficiencies
People with pica may have mineral or other deficiencies in their diet. Anemia (low iron levels) and zinc deficiencies are commonly found in persons with pica.
Mental health conditions
Pica can be associated with mental health conditions that develop in utero. It may also result from genetic conditions passed down from parents or it may develop spontaneously at some point in an individual’s life.
Medical conditions
Some medical conditions not associated with primary nutritional deficiencies may give rise to pica. Pregnancy is strongly associated with pica. Persons with sickle cell disease may also be at risk of developing the condition.
Medications
Certain medications can increase the risk of developing pica syndrome. However, it’s often unclear if the medication or the underlying condition is the true cause of pica disorder.
Family history
If members of your family have experienced pica, you may be at an increased risk. This is especially true if you have first degree relatives, such as parents, siblings, or children, with the condition.
How Do You Treat Pica?
Treatment for pica starts with a thorough medical examination to rule out any underlying medical conditions or mineral or nutrient deficiencies. When such conditions are found, medical treatment or nutritional supplementation will often correct the problem.
For individuals with pica disease and no known health condition or nutrient deficiency, behavioral therapy should be considered.
This often includes reducing access to the substance or providing an appropriate substitute with a similar texture. Furthermore, treating other co-occurring disorders, such as schizophrenia or autism spectrum disorder may decrease the symptoms of pica. This may include cognitive and behavioral interventions including redirection and rewarding individuals for not consuming any nonfood items.
Is Pica Dangerous During Pregnancy?
Pica can be dangerous during pregnancy. Consuming certain nonfood items can lead to poisoning which is not only harmful to the mother but has catastrophic implications for the fetus.
For instance, women who consume paint chips are at risk of lead poisoning. Exposure to lead while in utero increases the risk of neurological damage to the fetus, which may result in impaired memory, developmental delays and behavioral problems such as ADHD.
Despite the dangers, pica is not uncommon during pregnancy with studies indicating an estimated 27.8% of the pregnant or postpartum women that were studied worldwide have pica. Because pica can be linked to mineral or vitamin deficiencies, pregnant women should be screened for these conditions early in the pregnancy.
Anemia is prevalent in women of child-bearing age and is frequently associated with pica. It can also be very serious, especially for pregnant women.
It can lead to an increased risk of blood loss or infections, fatigue, dizziness and shortness of breath for the mother and low birth weight, preterm birth, intrauterine growth restriction, developmental delays and increased risk of death for the baby.
How do you treat pica during pregnancy?
The first step in addressing pica during pregnancy is to rule out any obvious causes such as a vitamin or mineral deficiency.
If testing reveals a deficiency, correcting it will likely correct the pica. If pica is a result of a mental health condition, a referral to a qualified mental health professional would be indicated to help the mother manage her condition in addition to comprehensive obstetric care.
Is pica dangerous?
Yes, pica can be dangerous. Consuming nonfood substances can cause a variety of physical conditions including poisoning, constipation or intestinal obstruction, dental issues, electrolyte imbalances leading to heart arrhythmias, and parasitic infections. These conditions can be fatal and must be addressed expeditiously to prevent serious outcomes.
Poisoning most commonly occurs from ingesting lead from paint chips. Lead poisoning has been shown to cause irritability, lethargy, headaches, abdominal pain, weight loss, numbness in feet and legs, loss of control of bodily movements (ataxia), seizures, cranial nerve paralysis, pressure in the brain causing the optic nerve to swell (papilledema), brain damage, coma and in some cases, death.
Constipation or intestinal obstruction can be caused by ingesting nonfood items such as clay, dirt, paper, rocks or pebbles. Intestinal obstruction will likely require surgical intervention. If not diagnosed and corrected early an obstruction can be fatal.
Dental issues result from consuming nonfood items that cause severe damage to the teeth and abrasion to the gums. This could impact eating and may result in a serious infection.
Electrolyte imbalance can cause heart arrhythmias. Severe heart arrhythmias can be life-threatening because they increase the risk of cardiac arrest, heart failure and stroke.
Parasitic infection can result from eating contaminated nonfood items such as dirt, clay, rocks or feces. These types of infections can lead to flu-like symptoms, vision problems, inflammation of the heart (myocarditis) and inflammation of the brain (encephalitis).
Finding Eating Disorder and Pica Treatment.
Treatment for pica and other eating disorders is available. The first step includes a thorough physical assessment and blood work to look for any underlying causes such as nutritional deficiency.
If testing reveals an obvious cause for the symptoms, correcting the underlying cause may be all the treatment needed.
For example, a pregnant mother who is eating large amounts of ice may be low on iron. Adding a daily iron supplement will likely treat the anemia and in turn, treat the pica.
For individuals with mental health disorders who show symptoms of pica, the treatment may include the use of mild aversion therapy, behavioral therapy or differential reinforcement.
In some cases, antipsychotic medications may help to manage pica. Finding qualified medical and mental health professionals who are experienced in treating pica is critical for creating the most effective treatment plans and supporting long term recovery.
