What is Pica?
The general public is most often aware of the more common eating disorders such as Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder. However, many people are not informed about the lesser known eating disorders such as Avoidant/Restrictive Food Intake Disorder (ARFID), Rumination Disorder, and Pica. I hope to provide more education around Pica below!
Pica can be defined as: persistent eating of nonnutritive, nonfood substances (over a period of at least 1 month), with the eating of these substances being inappropriate to the developmental level of the individual, not part of a culturally/socially normative practice, and severe enough to warrant additional clinical attention if occurring with another mental disorder. There is typically no aversion to food associated with Pica.
“Nonnutritive, nonfood substances” can be described as foods that do not have any nutritional content, not including diet products with low nutritional content. Typical substances ingested by someone struggling with Pica might include: paper, soap, cloth, hair, string, soil, chalk, paint, gum, metal, pebbles, charcoal, ash, clay, starch, or ice.
The two most common causes of Pica include malnutrition and iron deficiency anemia, followed by pregnancy. In these cases, imbalances in the body may contribute to nonfood cravings as the body tries to replenish low nutrient levels or eats nonfood items to help feel full. Pica can also be co-occurring with other developmental conditions and mental disorders such as autism, intellectual disabilities, and schizophrenia (though must be severe enough to warrant an additional diagnosis).
Pica is typically only diagnosed following medical complications such as intestinal obstruction and constipation/diarrhea from ingesting items not digestible, mouth or tooth injuries, intestinal ruptures, lead poisoning, iron deficiency, and parasitic disease. Risks associated with developing Pica might include neglect, lack of supervision, and developmental delay. In some cultures, the eating of nonnutritive substances such as dirt/earth may be a socially normative practice and would not be considered Pica.
There are a few ways you can support those struggling with Pica. I would first recommend reaching out to a medical professional and keeping an eye out for medical complications. Doctors can test for nutrient deficiencies and treat those first; in many cases the disordered eating behaviors may resolve after these deficiencies are corrected. If you have children, try childproof locks or high cabinets to keep items out of reach. If you believe you or someone you love is struggling with an eating disorder, please seek help from a psychologist and our team at Lift.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Written by Kelsey Riesbeck, our director of dietary services.