Understanding Pica:
Causes, Risks, and Treatment
Learn about the symptoms, risk factors, and treatment options for pica.
What Is Pica?
Pica is an eating disorder where individuals compulsively crave and consume non-food items including things like clay, soil, or paper. While more common among young children and pregnant women, it can affect anyone, of any age.
What are common warning signs of pica?
In addition to compulsive consumption of these non-food items such as dirt, raw starches, ice, charcoal, ash, paper or chalk, other warning signs of pica may include:
Nutritional deficiencies such as anemia:
Pica can result in iron or mineral deficiencies, leading to anemia, fatigue, and weakness.
Electrolyte imbalance:
Consuming non-food items may disrupt the body's electrolyte levels, affecting muscle and nerve function.
Irregular heartbeat:
Mineral imbalances caused by pica can impact heart rhythm, leading to palpitations or irregular beats.
Constipation and/or bowel blockage
Ingesting indigestible substances can cause digestive issues, including severe constipation or intestinal blockages.
What are risk factors for Pica?
Like other eating disorder types, Pica can happen to anyone. That said, certain populations are at a higher risk of developing Pica.
Pica is more common among pregnant women due to the nutrient deficiencies associated with pregnancy. You can learn more about pica and pregnancy here.
A study from the Autism Research Institute reveals that around 23% of children and up to 60% of adults on the autism spectrum may experience pica. One reason for this may be the sensory feedback an individual experiences when eating certain non-food items. This is similar to other autism-related behaviors like spinning or looking at lights.
Other Commonly Asked Questions
What causes pica?
Just like other eating disorders, there is no singular cause for pica.
Nutritional deficiencies like anemia or imbalances associated with pregnancy or dieting can be a contributing factor in the development of Pica.
Individuals on the autism spectrum have shown a rate of incidence with pica as have those with co-occurring mental health conditions such as OCD and Schizophrenia. That said, it’s important to remember, pica can happen to anyone!
Do individuals with pica have an aversion to food?
Individuals with pica tend to not have an aversion to food. This is in contrast to individuals with anorexia nervosa who may consume nonnutritive substances to feel full and avoid eating for fear of weight gain.
Since pica is not based on weight-loss, it’s not that serious. Right?
Pica is a serious mental health condition and eating disorder which requires attention. If you have been experiencing these cravings or engaging in this behavior for more than one month, we highly recommend reaching out to your primary care provider, calling the ANAD Eating Disorders Helpline at 1-888-375-7767, or searching the ANAD Treatment Directory to find treatment options in your area.
My baby/toddler is constantly putting things in their mouth. Is this pica?
Pica is not diagnosed in children under two years of age as this behavior and experience with non-food item objects is fairly common in babies and toddlers. To meet diagnostic criteria, the consumption of non-food items must be considered developmentally inappropriate.
What should I anticipate during my doctor’s visit?
First, individuals with pica may receive a comprehensive medical work-up to evaluate for any nutritional deficiencies or complications that are a result of ingesting the substance. Pica can have serious consequences including substances ingested resulting in toxicity, damage to the intestinal lining from being sharp, intestinal blockage or infections. Lab work, urine analysis and stool tests checking for signs of infections, poisoning and electrolyte imbalances are a component of the work-up.
Imaging tests checking for signs of blockage or internal damage from the ingestion may also be indicated. For example, development of a bezoar leading to obstruction or presence of damage to the intestinal lining from sharp objects can be the direct result of pica. Other tests as part of the medical work-up may include an EKG which can reflect consequences secondary to electrolyte abnormalities. If a deficiency such as iron or zinc is identified, replacement through nutritional supplementation should be offered.
What are the treatment options for pica?
Pica behavior in pregnant women and in young children usually subsides over time. For children with intellectual disabilities, reduction of access to the craved substance or attempting to replace it with a safer substitute substance with a similar texture is helpful.
Reinforcing alternative behaviors are a primary focus of treatment for pica. At times individuals may require near continuous monitoring while they develop coping skills and strategies to change the behavior. Differential reinforcement with reinforcing alternative behaviors, incompatible behaviors or any behavior other than the ingestion of the non-nutritive substance has been shown to be effective.
Additional Resources
Nutritional deficiencies such as anemia:
Pica can result in iron or mineral deficiencies, leading to anemia, fatigue, and weakness.
Electrolyte imbalance:
Consuming non-food items may disrupt the body's electrolyte levels, affecting muscle and nerve function.