How to identify pica?

November 27, 2025 •

4 min read

Studies indicate pica is most common in young children and pregnant women, although it can affect anyone. Learning how to identify pica involves recognizing the persistent consumption of non-nutritive substances and understanding its potential health implications.

Quick Summary

Pica involves compulsively eating non-nutritive substances for over a month. Diagnosis relies on a clinical history, observing behavioral patterns, and checking for health complications associated with the ingested items.

Key Points

Persistent Craving: The core sign of pica is a compulsive craving and consumption of non-food items for over a month.
Common Substances: Items like dirt, ice, paint chips, chalk, and hair are frequently consumed by individuals with pica.
Developmental Context: It is developmentally inappropriate behavior for children over two years old and is not part of a cultural tradition.
Underlying Causes: Nutritional deficiencies (especially iron) and mental health conditions are often linked to pica.
Physical Symptoms: Gastrointestinal issues (constipation, blockages) and poisoning (e.g., lead) are significant complications to watch for.
Professional Diagnosis: A healthcare provider diagnoses pica based on history, physical signs, and specific test results for related health problems.
Treatment Focus: Management addresses both the underlying causes, such as nutritional deficiencies, and the behavioral aspects of the disorder.

Understanding Pica: What It Is

Pica is a complex feeding and eating disorder defined by the persistent eating of non-nutritive, non-food substances for at least one month. The behavior must be developmentally inappropriate for the individual's age (e.g., typically not diagnosed in children under two) and not part of a culturally or socially normative practice. The term originates from the Latin word for the Eurasian magpie, a bird known for eating a variety of unusual objects. Pica is a compulsive behavior, meaning individuals find it very difficult to control the urge to eat these items.

Key Signs to Look For

Identifying pica involves observing a combination of behavioral patterns and potential physical health indicators that result from the compulsion.

Behavioral and Craving Patterns

The primary symptom of pica is the persistent craving and eating of substances with no nutritional value. These cravings can be intense and focused on a single type of item or multiple items.

Commonly ingested non-food items include:

Ice (pagophagia)
Dirt, soil, or clay (geophagia)
Starch (amylophagia)
Hair, string, or thread (trichophagia)
Chalk
Paper
Paint chips
Pebbles
Feces (coprophagia)
Soap

Physical Health Indicators

The consequences of ingesting non-food items can lead to a variety of health problems, and these physical signs can be crucial for identifying pica.

Gastrointestinal Issues: Look for severe constipation, abdominal pain, diarrhea, or intestinal blockages caused by indigestible items.
Nutritional Deficiencies: Anemia (specifically iron deficiency), and deficiencies in zinc or other minerals, are frequently associated with pica. This can cause symptoms like fatigue.
Poisoning: Ingesting items like old paint chips can lead to lead poisoning, which can cause serious neurological damage.
Infections: Consuming soil or feces can lead to parasitic infestations and infections.
Dental Problems: Chewing on hard objects like ice, pebbles, or metal can cause chipped teeth, severe dental abrasion, or mouth injuries.

How Pica is Diagnosed

There is no single laboratory test for pica. A healthcare provider, such as a doctor or psychiatrist, will make a diagnosis based on the patient's history and behavior, using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5-TR).

The diagnostic process often includes:

Patient Interview: A detailed discussion about what substances are being eaten and for how long. Honesty is crucial, even if it feels embarrassing.
Lab Testing: Blood tests check for nutritional deficiencies like anemia, as well as lead poisoning. Stool tests can detect parasitic infections.
Imaging Tests: X-rays or other imaging may be used to check for intestinal blockages or internal damage.

Pica Identification in Different Populations

Pica can present differently depending on the individual's age and circumstances.

Children

While toddlers and infants often put objects in their mouths as a form of exploration, a pica diagnosis is reserved for persistent eating of non-food items in children over the age of two. Caregivers should observe for deliberate, repeated ingestion of a specific item or items.

Adults and Pregnant Women

In adults, pica can be linked to other mental health conditions like autism, intellectual disabilities, or schizophrenia. It is also common during pregnancy, often triggered by nutritional deficiencies, and typically resolves after birth.

Comparison of Non-Food Ingestions

To properly identify pica, it's important to distinguish it from other forms of non-food consumption.


Feature	Pica	Normal Mouthing in Toddlers	Culturally Normative Practice
Persistence	Chronic (at least one month) and compulsive.	Temporary, part of developmental exploration.	Practiced deliberately as part of a ritual or custom.
Developmental Context	Inappropriate for developmental level (typically diagnosed >2 years).	Normal and expected for age.	Not related to developmental stage.
Reason	Often linked to nutrient deficiencies, mental health, or stress.	Curiosity about the world.	Medicinal or ceremonial purpose.
Associated Health Risks	High risk of poisoning, blockages, and infections.	Lower risk, but still a concern for choking or accidental ingestion.	Risks vary depending on the substance and practice.

When to Seek Professional Help

If you suspect that you or someone you know has pica, seeking professional medical advice is the most important step. A healthcare professional can provide a proper diagnosis, investigate potential underlying causes like nutritional deficiencies, and address any serious health complications. It is a medical condition, not a personal failing, and treatment can help manage the behavior and mitigate health risks. A team-based approach involving a doctor, dietician, and therapist may be necessary for comprehensive care.

Conclusion

Identifying pica requires careful observation of persistent, compulsive eating of non-food substances. It's important to consider developmental appropriateness, cultural practices, and look for associated physical health indicators such as anemia or intestinal issues. A proper diagnosis from a healthcare professional is essential for uncovering and addressing potential underlying causes, whether they are nutritional, psychological, or environmental. The key is to recognize the signs and seek timely medical evaluation to ensure safety and effective management.

Medscape's Overview of Pica provides additional clinical information on this condition.

Frequently Asked Questions

Pica involves the persistent, compulsive eating of non-food items for over a month and is considered developmentally inappropriate for children over two years of age. Normal toddler behavior includes mouthing and occasional ingestion of objects as a way to explore their environment, but it is not persistent or compulsive.

While individuals with pica may eat almost anything, common items include dirt, clay, ice, hair, paint chips, chalk, paper, pebbles, and feces.

Yes, nutritional deficiencies, especially iron-deficiency anemia, are one of the most common causes associated with pica. Other deficiencies, such as low zinc levels, may also be a factor.

Pica can be very dangerous depending on the substance ingested. Complications can include lead poisoning (from paint), parasitic infections (from dirt), intestinal blockages (from hair or pebbles), and dental damage.

A doctor, typically a pediatrician for children or a general practitioner for adults, can make a pica diagnosis based on clinical history. A mental health professional, such as a psychiatrist or therapist, is also important for evaluation and treatment.

Treatment for pica is multi-faceted and may involve addressing nutritional deficiencies with supplements, using behavioral therapies to manage cravings, and medical intervention for any resulting health complications. For pregnant women and children, it can sometimes resolve on its own.

Yes, pica can affect adults. When it occurs in adulthood, it is often associated with conditions like intellectual disabilities, autism spectrum disorder, or schizophrenia. It can also develop during pregnancy.

If you suspect pica, you should gently and non-judgmentally approach the person about their eating habits and encourage them to see a healthcare provider. Honesty with the doctor is key to a proper diagnosis and treatment plan.