Pica Explained

Medically Reviewed By Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT
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Pica is an eating disorder where someone compulsively eats nonfood items. It is more common in children and those who have intellectual or developmental impairments. This article will define pica. It will also discuss the symptoms, causes, and treatments of the condition.

What is pica?

girl on bike eating
Jessica Klaus/Stocksy United

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines pica as an eating disorder wherein someone persistently eats nonnutritive or nonfood items for more than 1 month.

Pica is most common in young children. It affects around 10–30% of children under the age of 6. It also affects children of other ages and adults who have developmental and intellectual impairments. Occasionally, pica can affect people who are pregnant. However, it is possible for anyone to develop pica.

Most of the time, pica is an isolated disorder. However, it can occur alongside other disorders, such as obsessive-compulsive disorder (OCD), schizophrenia, and trichotillomania.

Common nonfood items that people with pica ingest include:

Most common items ingestedLess common items ingested
dirtash
clayglue
flaking painthair
icefeces
charcoal
paper
cloth
baby powder
coffee grounds
eggshells

If you or your child is persistently ingesting nonfood items, contact a doctor or mental health professional.

What are the symptoms of pica?

The symptoms of pica generally stem from the nonfood items you ingest. These symptoms include:

If you or a child has ingested nonfood items and are experiencing any of these symptoms, contact your doctor.

If you are pregnant and find that you are persistently ingesting nonfood items — such as soil, burnt matches, or toothpaste — contact your doctor. Certain nonfood items are potentially dangerous to the fetus. Your doctor can then monitor your iron levels, which is a common cause of pica in pregnancy.

Visit our hub to learn more about mental health and behavior.

What causes pica?

The exact cause of pica is unknown. However, there are certain risk factors that may increase your chance of developing the condition.

These factors include:

  • stress
  • cultural factors
  • learned behaviors
  • an underlying mental health condition
  • nutritional deficiency
  • child neglect
  • pregnancy
  • epilepsy
  • a family history of mental health issues

Having any of these risk factors does not necessarily mean you will develop pica.

What are the potential complications of pica?

In many cases, pica does not cause any physical harm. However, it can potentially lead to serious complications without treatment.

These complications include:

  • obstruction in your intestines
  • lead poisoning
  • parasitic infestation
  • infection
  • tooth injury

If you are pregnant, pica is potentially dangerous not only to you but to the fetus as well. These complications can include:

  • reduced weight gain
  • low iron
  • premature birth
  • a low birth weight in the infant

How do doctors diagnose pica?

There are certain diagnostic criteria that must be met in order for a doctor to give a diagnosis of pica. The DSM-5 lays out the following criteria:

  • A person ingests nonfood, nonnutritive items for a minimum period of 1 month.
  • The ingestion of these items is not appropriate for the developmental stage of the person.
  • Ingesting the items is not part of a cultural tradition.
  • If the ingestion of these items co-occurs with another disorder, it is persistent enough to warrant a second diagnosis.

Typically, doctors will not diagnose pica in children under 2 years of age, as it is a natural part of development at that stage to put these types of items in their mouths.

If your doctor does believe you have pica, they will usually check for any weight loss and nutritional deficiencies. They may also choose to run blood tests and stool tests to check for lead poisoning, infection, or infestation.

In some cases, a doctor may diagnose pica when you visit their office or an emergency room for another issue, such as intestinal obstruction, lead poisoning, or parasitic infestation.

Visit our hub to read more about eating disorders.

What are the treatments for pica?

Treatment for pica typically begins with a focus on any underlying physical symptoms you are experiencing.

For example, if you have lead poisoning, an obstruction, or a parasitic infestation, your doctor will treat that issue first. They will also treat any constipation, diarrhea, or stomach issues you may be experiencing.

They may also refer you to a mental health professional for behavioral therapy. A mental health professional will help to discover what might be compelling you to eat those items. They can also teach you behavioral modification techniques to help you manage your symptoms.

Summary

Pica is a mental health condition that involves eating nonfood items persistently. It is most common in children but can develop in anyone.

The exact cause of pica is unknown. However, certain risk factors — stress, pregnancy, and neglect — can increase your chance of developing the condition.

The ingesting of nonfood items with pica can lead to serious medical issues, such as intestinal obstruction, lead poisoning, and parasitic infestation.

Other than treating any underlying medical issues, there is not a lot known about specific treatment for pica. However, a mental health professional can teach you behavioral modification techniques that may help.

If you or your child has persistently ingested nonfood items for at least a month, contact your doctor.

If you are pregnant and experiencing pica, work with your healthcare professionals to learn how to curb your cravings for nonfood items. This way they can monitor your iron and nutritional status as well as the health of the fetus.

Early intervention for eating disorders

Eating disorders can have a severe effect on your life and the lives of those around you. Early intervention and treatment are often imperative to your recovery. 

If you believe that you or someone close to you is living with an eating disorder, contact a doctor. 

You can also contact the National Eating Disorder Association for support and advice:

  • Call or text: 800-931-2237 (only available during set hours)
  • Access their online chat (only available during set hours)
  • Text their crisis text line: Text NEDA to 741741

The Substance Abuse and Mental Health Services Administration (SAMHSA) runs a 24-7 disaster distress helpline: 800-985-5990 (call or text)

Other available resources include:

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Medical Reviewer: Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT
Last Review Date: 2022 May 31
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.