Pica is an eating disorder where a person compulsively craves and eats materials that are not food.

During infancy, babies explore their environment using their mouth. Infants innocently place objects in their mouth to learn about the world around them. These objects are often not food and babies curiously use them to learn about shapes, textures and sizes. At some point, babies pass through this phase and begin to explore their environment through other means. Pica is a condition that goes past innocent exploration. This type of eating disorder is usually temporary and treatment can help people prevent serious side effects.

What Is Pica?

Pica is an eating disorder where a person compulsively craves and eats materials that are not food. These items may be harmless or more dangerous. These objects have no nutritional value and include items like dirt, paint, glue and sand.

Pica Symptoms

Signs and symptoms of pica are present when individuals compulsively eat items that are not traditionally considered food. People may eat objects such as paint, clay, soil or fecal material. Pica symptoms can be present if efforts have been unsuccessful in helping a person restrict behaviors. Pica is identifiable if a person’s actions are considered inappropriate for a person’s developmental stage or not part of their culture or religious practice.

Some of the most common pica symptoms include gastrointestinal symptoms like:

  • Stomach pain
  • Nausea
  • Bowel problems
  • Bloating caused by intestinal blockages
  • Blood in the stool, which can suggest that a stomach ulcer resulted from eating nonfood items
  • Tiredness
  • Fatigue

Causes of Pica

If someone is unfamiliar with the disorder, they may wonder, “What causes pica?” Biological irregularities are not common in people with pica. This condition is commonly caused by:

  • Iron deficiency, anemia and malnutrition: In these conditions, the body is trying to rectify a shortage of nutrients.
  • Pregnancy: Being pregnant can cause pica syndrome, especially in women who demonstrated similar behaviors during childhood or who have a family history of pica.
  • Dieting: A strict diet can be another cause of pica eating disorder because people may use nonfood items to achieve a feeling of fullness.
  • Mental health disorders: Other causes of pica include mental health disorders that impair functioning such as obsessive-compulsive disorder and schizophrenia.
  • Developmental disabilities: Autism or trauma to the brain or brain irregularities can be other reasons for pica.

Eating non-food items can be taught as part of cultural or religious practice. Pica may also be a behavioral response to emotional stressors like trauma, family disturbance and lack of structure. A lack of parental supervision or neglect can also result in pica eating disorder.

Nutritional Deficiency

Malnutrition and nutritional shortages in iron and zinc can trigger specific cravings. These cravings often fail to provide the necessary minerals a person needs. These nutrient shortages may co-occur with iron-deficiency anemia or pregnancy.

Mental Health Disorders

Mental health disorders and developmental disabilities can cause pica symptoms. When pica occurs with intellectual disabilities, people may be unable to tell the difference between edible and inedible items.

Diagnosing Pica

There is currently no specific test that can diagnose pica. Comprehensive medical tests are used to assess for obstruction, toxicity and anemia. As pica often occurs in people with malnutrition and nutrient deficiencies, physicians typically use blood tests to test iron, zinc and hemoglobin levels. X-rays may also be used to check for obstructions in the digestive tract. A physician may assess for potential infection if they suspect that a person has eaten objects contaminated with bacteria.

Before making a pica diagnosis, a physician will assess whether there are other mental health disorders present. The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders has several diagnostic criteria used for formal diagnosis. Pica diagnosis criteria require that a person eats non-food items for longer than one month, behaviors occur at an age that is not developmentally appropriate or part of cultural practice, and their condition is severe enough to warrant medical attention.

Who Is at Risk for Pica?

Pica frequently occurs in young children and people with autism and other developmental and intellectual disabilities.  Pica can occur in people with epilepsy, pregnant woman, and individuals with a brain injury. A pica eating disorder can lead to significant health problems, such as lead poisoning and iron-deficiency anemia.

Pica risk factors can include:

  • A family history of psychopathology
  • Disorganized family structure
  • Lack of environmental resources
  • Pregnancy
  • Epilepsy
  • Brain damage and cognitive impairments
  • Pervasive developmental disorders

Pica Statistics

To better understand pica, several studies have been conducted. Some statistics about pica from researchers include:

  • Behavioral interventions for pica have reduced the severity of pica in 80 percent of people with intellectual disabilities.
  • Pica disorder occurs in 25 percent to 33 percent of young children.
  • Amongst individuals with cognitive impairments, pica most often occurs in people between the ages of 10-20 years old.
  • The incidence of pica is equal in males and females.

Pica Treatment

Pica treatment should be individualized and based on a specific cause. Pica treatment requires close medical attention because pica may have significant medical complications. Pica commonly improves as children get older but can remain a problem for those with developmental disabilities and mental health disorders.

Managing a patient’s environment and ongoing treatment is essential for effective treatment. Pica may be treated via nutritional supplements and changes in diet if mineral deficiencies are identified as the cause of the disorder. Pica treatment can also include medication or behavioral interventions.

Behavioral interventions are common in a pica treatment plan. Differential reinforcement could be used, where people are praised with positive reinforcement if pica is not attempted and given consequences if pica behaviors occur. Pica therapy can include discrimination training between edible and non-edible foods, where negative consequences are incurred if pica behaviors happen. Aversion therapy can be used, where aversive sensory stimuli are presented if pica is attempted. Ignoring a person’s behavior and withdrawing attention is another useful behavior technique.

Drug therapy can be used to help individuals manage behavioral problems, which can have a positive result with a co-occurring pica disorder. Medication for pica may be warranted if behavioral treatments don’t work. Medication can assist a person in reducing behaviors if pica occurs with a developmental or intellectual disability.

Minimal research has been conducted regarding medication and pica treatment. However, some researchers believe that reduced amounts of dopamine in the brain may cause pica. Thus, medications that increase dopamine may be useful in treating pica disorder.

Pica and Substance Abuse

Pica can be classified as an addiction, as it is characterized by a compulsion to ingest substances that are harmful. Although rare, pica can co-occur with other substance use disorders. People with pica disorder may be more prone to substance abuse and take great pleasure in drug use. Mental illness is the primary connection between pica and substance abuse. Obsessive-compulsive disorder can be linked to both conditions.

If you or a loved one struggle with a drug or alcohol addiction and a co-occurring disorder like pica, treatment is available. At the Recovery Village, a team of professionals can offer you personalized treatment to help you heal physically and mentally. To learn more about treatment options, call The Recovery Village today to speak with a representative.

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Editor – Nicole LaNeve
Nicole leads a team of passionate, experienced writers, editors and other contributors to create and share accurate, trustworthy information about drug and alcohol addiction, treatment and recovery for The Recovery Village and all Advanced Recovery Systems sites. Read more
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Medically Reviewed By – Tracy Smith, LPC, NCC, ACS
Tracy Smith is a Licensed Professional Counselor, a Nationally Certified Counselor, an Approved Clinical Supervisor, and a mental health freelance and ghostwriter. Read more
Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.