What is pica?
Pica is a feeding and eating disorder defined by the persistent consumption of non-nutritive, non-food substances for at least one month. The name 'pica' comes from the Latin word for magpie, a bird known for its tendency to eat unusual objects. This behavior is considered clinically significant only if it is developmentally inappropriate (generally not diagnosed in children under two) and not part of a culturally supported practice. The disorder can range from relatively harmless habits, like eating ice, to dangerous ones, such as consuming lead-based paint chips or contaminated soil.
Common substances ingested
People with pica may crave and eat a wide range of substances. Some of the most frequently reported items include:
- Ash or cigarette butts
- Baby powder or talcum powder
- Chalk, clay, dirt, or soil (geophagia)
- Coffee grounds
- Eggshells
- Feces
- Hair, string, or thread (trichophagia)
- Ice (pagophagia)
- Laundry starch (amylophagia)
- Paint chips
- Paper
- Pebbles or stones
- Pet food
- Soap
Potential causes of pica
While the exact cause of pica is not fully understood, several factors have been identified that may contribute to its development. It is likely that a combination of these factors plays a role.
- Nutritional Deficiencies: A shortage of certain vitamins and minerals, most notably iron (anemia) and zinc, is strongly linked to pica. This is particularly common in pregnant women, where iron deficiency is a known risk factor. Consuming non-food items, such as clay, may be an unconscious attempt to replenish missing nutrients, although it rarely provides the required sustenance.
- Mental Health Conditions: Pica can occur alongside other mental health conditions, including autism spectrum disorder, intellectual disability, obsessive-compulsive disorder (OCD), and schizophrenia. In these cases, it may be a learned coping mechanism or result from an inability to distinguish between edible and non-edible items.
- Stress and Emotional Distress: High levels of stress, anxiety, or emotional trauma can trigger pica as a coping mechanism. This is sometimes seen in children experiencing neglect or unstable home environments.
- Sociocultural Factors: In some cultures, certain forms of pica, such as eating specific clays, are a socially accepted practice for perceived health benefits. A diagnosis of pica would not apply in these circumstances unless the behavior becomes severe enough to warrant clinical attention.
Dangers and complications of pica
Depending on the substance ingested, pica can lead to a range of severe health problems. The risks are typically higher for those who consume toxic or sharp items.
- Poisoning: Ingesting items like lead-based paint chips can cause severe lead poisoning, which can lead to brain damage and other neurological issues.
- Intestinal Blockage or Perforation: Eating indigestible objects like hair, pebbles, or string can cause blockages in the digestive tract, which may require surgical removal. Sharp items can also cause intestinal tears.
- Infections: Consuming soil or animal feces can expose an individual to dangerous parasites and bacteria, leading to infections that can damage internal organs.
- Dental Damage: Chewing on hard objects can result in cracked or worn-down teeth and other mouth injuries.
- Malnutrition: Pica may interfere with the intake of regular, nutritious food, which can worsen nutritional deficiencies or cause further malnutrition.
Comparing pica in different populations
| Feature | Pica in Children | Pica in Pregnant Women | Pica in Adults with Developmental Disorders |
|---|---|---|---|
| Typical Onset | Most common in early childhood; often developmentally normal before age 2. | Often begins during the first trimester. | Can persist for years, especially with more severe disabilities. |
| Common Triggers | Curiosity, nutritional deficiencies (e.g., anemia), and stress from neglect. | Iron-deficiency anemia is a significant risk factor. | Intellectual disability, autism spectrum disorder, and sensory feedback. |
| Prognosis | Often resolves spontaneously or with behavioral intervention as the child matures. | Usually resolves on its own after giving birth. | Can be more severe and chronic, requiring long-term management. |
| Associated Risks | Lead poisoning from old paint, parasitic infections from soil. | Worsening of anemia, intestinal problems from ingesting certain substances. | Higher risk of severe medical complications due to persistent, uncontrolled behavior. |
Treatment and management of pica
Treating pica typically requires a comprehensive, multidisciplinary approach that addresses both the underlying cause and the resulting complications.
- Medical Evaluation: The first step is a thorough medical evaluation to check for any physical complications, such as intestinal issues, poisoning, or infections. Blood and stool tests can identify nutritional deficiencies and parasitic infections.
- Nutritional Support: If a nutritional deficiency is identified, supplements for iron, zinc, or other minerals may be prescribed. This is often an effective first-line treatment, especially in pregnant women and children.
- Behavioral Therapy: Behavioral strategies are often considered the most effective long-term treatment for pica. Techniques include:
- Differential reinforcement: Rewarding desired or incompatible behaviors while ignoring or redirecting pica behavior.
- Environmental enrichment: Increasing positive stimulation to reduce the focus on non-food items.
- Aversive therapy: Using mild, aversive consequences to discourage the pica behavior.
- Environmental Management: For those with developmental disabilities, constant supervision and modifying the environment to remove access to craved items are crucial for safety.
- Mental Health Treatment: For individuals with co-occurring mental health disorders, addressing those conditions with therapy and medication can help reduce pica behaviors.
Conclusion
What is it called when you eat non-nutritional substances? The medical term for this is pica, a complex eating disorder with diverse triggers, from nutritional deficiencies to mental health disorders. While it often resolves in children and pregnant women, it can become chronic and dangerous if left unmanaged. Given the serious health risks, which include poisoning, infection, and intestinal blockages, professional medical and psychological evaluation is essential. Effective treatment plans are personalized and often involve nutritional supplementation, behavioral therapy, and environmental changes. Raising awareness and reducing the stigma associated with pica are critical steps toward ensuring affected individuals receive timely and compassionate care.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. If you suspect you or someone you know has pica, please consult a healthcare professional.
For more information on eating disorders, visit the National Association of Anorexia Nervosa and Associated Disorders (ANAD).
