What is Pica?
Pica, pronounced "PIE-kuh," is an eating disorder characterized by a persistent and compulsive appetite for non-nutritive substances. The name is derived from the Latin word for magpie, a bird known for its indiscriminate and random gathering of objects. Unlike the normal exploratory behavior of infants and toddlers who put objects in their mouths, pica is a diagnosis reserved for individuals who are developmentally aware enough to know the difference between food and non-food, and whose behavior persists for at least one month. People with pica can crave and consume a wide range of items, from harmless substances like ice to extremely dangerous materials such as paint chips or metal.
Causes and Risk Factors for Developing Pica
While the exact cause of pica is not fully understood, a combination of nutritional, psychological, and environmental factors are often involved.
Nutritional Deficiencies
Nutritional deficiencies, particularly iron deficiency anemia and low zinc levels, are a common association with pica. The body's attempt to compensate for a mineral shortfall may trigger specific cravings for non-food items, though the substances themselves rarely provide the missing nutrients. For instance, pregnant women, who are often iron deficient, may develop a craving for ice (pagophagia).
Psychological and Developmental Factors
Stress and anxiety can act as triggers or coping mechanisms for individuals with pica. The behavior may provide a form of sensory feedback or a calming ritual for some. Pica is also more prevalent in individuals with certain mental health and developmental conditions, including:
- Autism spectrum disorder
- Intellectual disabilities
- Schizophrenia
- Obsessive-compulsive disorder (OCD)
Environmental and Socioeconomic Factors
Learned behavior, social practices, and socioeconomic status can also influence the development of pica. In some cultures, certain forms of pica, such as the eating of specific types of clay, may be culturally accepted and not considered a disorder. However, in other contexts, poverty and neglect during childhood are associated with higher rates of pica.
Potential Health Consequences
The health risks of pica depend heavily on the type of substance being ingested. While eating some non-food items like ice is relatively benign, ingesting others can lead to severe and life-threatening complications.
Physical Complications
- Poisoning: Ingesting toxic substances like lead from paint chips or mercury can cause heavy metal poisoning, leading to brain damage, organ failure, or death.
- Intestinal Blockage: Swallowing indigestible items such as hair, pebbles, or plastic can cause bezoars (solid masses) that obstruct the intestines and may require surgical removal.
- Infection: Eating soil, clay, or feces can expose an individual to dangerous parasites and bacteria, resulting in infections.
- Dental Damage: Chewing on hard items like rocks or bricks can cause tooth decay, cracks, and other oral injuries.
Mental and Social Effects
Individuals with pica often experience embarrassment or shame, which can prevent them from seeking help. The secrecy surrounding the behavior can lead to social isolation and significant emotional distress. Addressing the psychological aspect is a key part of effective treatment.
The Spectrum of Non-Food Cravings: Pica vs. Rumination Disorder
Understanding the differences between pica and other eating disorders is crucial for correct diagnosis and treatment.
| Feature | Pica | Rumination Disorder |
|---|---|---|
| Core Behavior | Compulsive eating of non-nutritive, non-food substances. | Repeated regurgitation and re-chewing of food. |
| Substances Involved | A wide variety of inedible items like soil, paper, hair, or ice. | Food that has already been ingested. |
| Purpose | Often linked to nutrient deficiencies, sensory feedback, or psychological coping. | Can be a self-soothing behavior, but the primary action is regurgitation. |
| Mechanism | Ingestion of inedible items. | Involuntary regurgitation after eating, followed by re-chewing or re-swallowing. |
| Risks | Poisoning, infection, intestinal obstruction, dental damage. | Malnutrition, dental erosion from stomach acid, social isolation. |
Diagnosis and Treatment of Pica
Diagnosis
A diagnosis of pica is made by a healthcare professional, typically after a thorough medical and psychological evaluation. According to the DSM-5, the following criteria must be met:
- The behavior of eating non-food items must persist for at least one month.
- The behavior is considered developmentally inappropriate for the individual's age.
- The behavior is not part of a culturally supported or socially normative practice.
- If it occurs with another mental or medical condition, it must be severe enough to warrant independent clinical attention.
Diagnostic tests often include blood tests to check for nutritional deficiencies and lead poisoning, as well as imaging tests like X-rays to look for internal blockages.
Treatment Options
Treatment for pica is tailored to the underlying cause and can involve a multidisciplinary approach.
- Nutritional Intervention: If nutritional deficiencies are the root cause, dietary changes and supplements can be highly effective. Correcting the deficiency can often resolve the craving.
- Behavioral Therapy: Techniques such as mild aversive therapy and differential reinforcement can help individuals learn to associate the undesirable behavior with negative consequences while rewarding healthy eating habits.
- Environmental Adjustments: In some cases, removing the non-food items from the individual's environment can help prevent the behavior.
- Addressing Underlying Conditions: For those with co-occurring mental health disorders, treating the primary condition with therapy or medication is crucial.
Conclusion
While the answer to "What is it called when you put non-food items in your mouth?" is pica, the condition is far more complex than a simple definition. It is a serious eating disorder with potentially severe health complications, driven by a range of factors from nutritional deficits to underlying mental health issues. Prompt diagnosis and a comprehensive treatment plan are essential for managing pica and mitigating its risks. If you or someone you know exhibits symptoms of pica, it is vital to seek professional medical advice to ensure a proper diagnosis and appropriate intervention. Early intervention can prevent serious physical harm and improve the overall quality of life.
Beat Eating Disorders offers support and information on pica and other eating disorders.
