Pica eating disorder: what is it?

What’s on the menu today? If it’s paint, soil, ice, chalk, glue, or another similarly non-nutritional item, you might be looking at a case of pica eating disorder. Pica isn’t as well known as some other eating disorders, like anorexia nervosa or bulimia, but it’s common in certain populations. 

Ro

Improve and support your health from the comfort of home

Learn more

Pica eating disorder is the compulsive eating of non-food items. These items might be paint, soil or clay, laundry starch, ice, feces, chalk, glue, coffee grounds, eggshells, or many other things (Al Nasser, 2020).

Pica has been known as a medical condition for well over 2,000 years. The term “pica” comes from the Latin word for the magpie bird because magpies are said to gather and eat many different objects (Rabel, 2015).

For a diagnosis of pica, a person must have eaten non-edible items for at least a month. If eating that item is part of a cultural tradition, it’s not considered pica. For instance, clay eating is considered normal in some parts of Africa and the Middle East. Also, eating non-edible items isn’t deemed abnormal in children under 24 months of age (Al Nasser, 2020).

The risks of pica depend on what’s being eaten (Al Nasser, 2020):

• Paint chips or clay—If these items contain lead, there’s a serious concern about lead poisoning. Lead poisoning can cause neurological problems (like seizures and coma); behavioral problems (like difficulty paying attention or focusing); and digestive problems (like abdominal pain, anorexia, and vomiting) (Hauptman, 2017)

• Laundry starch—Eating laundry starch can lead to iron deficiency, high blood sugar, and obesity.

• Ice—While eating ice is relatively harmless, overeating it can lead to iron deficiency, as well as tooth decay and sensitivity.

• Soil or clay—The most significant risks are constipation, low potassium levels, nutritional deficiencies, intestinal blockages, lead poisoning, and bacteria or parasite infection. Parasite infection can be severe, with symptoms including fever, fatigue, coughing, wheezing, abdominal pain, vision loss, retina damage, and eye inflammation (Woodhall, 2017).

• Rocks or stones—Eating these can lead to constipation and blockages in the digestive tract.

• Sharp objects—Eating sharp objects can cause digestive problems, like pain, bleeding, and infection. Items like metal scraps can tear the lining of the esophagus, stomach, and intestines.

• People with a family history of pica

• Children, especially children of lower socioeconomic status (Leung, 2019)

• Pregnant, menstruating, or lactating women (Rabel, 2016). One study found that a whopping 28% of pregnant women worldwide have pica (Fawcett, 2016).

• People with developmental or intellectual disabilities

• People with mental disorders, including schizophrenia, obsessive-compulsive disorder (OCD), degenerative neurological diseases (such as Alzheimer’s), and psychosis (Kar, 2015; Funayama, 2018; Rabel, 2016)

• People with nutritional deficiencies, especially iron and zinc (Miao, 2015). Low levels of iron are the most common cause of anemia.

There’s no known direct cause of pica. In some people, especially those with OCD, pica is considered a mental health disorder (Al Nasser, 2020; Kar, 2015).

Eating soil and clay is linked with iron and zinc deficiencies. Some researchers think that people eat these substances to supplement these deficiencies. These researchers point out that eating soil or clay doesn’t increase a person’s levels of iron. But it’s also possible that eating the soil or clay is actually causing the deficiencies by absorbing nutrients from the digestive system (Al Nasser, 2020; Miao, 2015).

There might be other physiological reasons for eating soil or clay. In pregnant women, these substances may bind with toxins and keep them away from the developing embryo when it’s most likely to be damaged by them (Al Nasser, 2020). Of course, there are also significant potential risks of eating soil or clay, so it’s not worth trying at home.

Ice eating is a form of pica linked with anemia, which can make you feel weak and tired. People with anemia may eat ice because it can stimulate increased blood flow to the brain. This increases their alertness and makes them feel less tired (Rabel, 2016).

There’s no specific test for pica eating disorder. Because the symptoms of pica can vary so much, depending on what substance is being eaten, testing varies widely. Your provider may order comprehensive tests for gastrointestinal obstruction, infection by bacteria or parasites, lead toxicity, and nutritional deficiencies (Al Nasser, 2020).

Your provider may also inspect your teeth for damage from eating hard objects. You might also be assessed for other psychological conditions.

Pica isn’t necessarily treated. In pregnant women, pica usually spontaneously disappears (Al Nasser, 2020). However, if you’re pregnant and are experiencing pica, it’s still worth discussing with your healthcare provider. They might want to check for any nutritional deficiencies or other conditions that could affect you and your baby.

In most young children, pica usually disappears after they’ve been taught the difference between edible and inedible substances (Leung, 2019). In children and adults with learning disabilities, behavioral therapy usually stops pica (McNaughten, 2017; Call, 2015).

If tests show that you have nutritional deficiencies, you might need to take dietary supplements or change your diet. For instance, if you have iron-deficiency anemia, you may need iron supplements for iron replacement.

People with other mental health conditions might be prescribed medications to treat their condition (Kar, 2015).

Talk to your healthcare provider if you’re concerned about pica.

---

How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Editorial Guidelines | Medical Review Process

Current version

May 25, 2021

Written by

Alison Dalton

Fact checked by

Steve Silvestro, MD

---

About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.