What is pica? Causes, symptoms, and treatment options

Eating disorders are complex conditions that cause severe disturbances to eating habits and food behaviors. While many eating disorders involve eating too much or too little food, there’s one eating disorder that involves eating non-food items. Pica is a condition that causes people to eat items that have no nutritional value. Although often harmless, some pica behaviors can lead to serious health complications. 

Learn how to recognize the signs and symptoms of pica so that you can access treatment for yourself or a loved one. 

What is pica?

Pica is an eating disorder that causes people to compulsively (uncontrollably) eat non-food items that offer no nutritional value, like paper, paint, string, and soap. 

To be diagnosed with pica, these food behaviors must continue for at least one month, be inappropriate for a person’s developmental stage, and not be considered socially normative or culturally acceptable. 

Anyone can develop pica, but it’s most common in young children, people who are pregnant, and people with intellectual disabilities. 

How to recognize common signs of pica

Pica causes people to consume non-food items like paper, soap, hair, string, wool, soil, chalk, talcum powder, paint, gum, coffee grounds, metal, rocks, charcoal, ash, clay, starch, or ice. 

Some pica habits, like eating ice, are somewhat harmless, but eating dangerous or toxic items can lead to a range of complications. For example, eating paint can cause lead poisoning, while eating dirt or feces can increase the risk of bacterial or parasitic infections.

Other pica health risks include: 

• Poor nutrition 
• Dental issues, like damage to teeth and gums
• Anemia
• Electrolyte imbalance
• Gastrointestinal complications, like constipation, intestinal obstruction, and ulcers
• Irregular or abnormal heart rhythms 

What causes pica?

There are several potential reasons that people develop pica, including nutritional deficiencies, psychological factors, and environmental influences. 

• Both extreme dieting and malnourishment can cause people to eat non-food items to help them feel full. For some people, pica is the result of being deficient in nutrients like iron, calcium, or zinc.
• Pica has been linked to mental health conditions like autism spectrum disorder, anxiety, depression, schizophrenia, and obsessive-compulsive disorder (OCD).
• Certain childhood environmental factors, like growing up in poverty or exposure to toxins, may play a role in developing pica. Pica is also thought to be a coping method for children who experience abuse or neglect. 

Five types of support to consider for pica

Treating pica typically requires a coordinated effort from multiple healthcare professionals, including primary care doctors, therapists, and registered dieticians. Treatment begins with a thorough health assessment. After that, it varies based on each person’s needs. 

Typically, treatment will involve the following key components:

1. Medical evaluation 

If you or someone you know is showing signs of pica, consider getting checked for underlying medical conditions or deficiencies. This includes bloodwork to test for nutrient deficiencies, screenings for conditions like lead poisoning, and x-rays to check for internal blockages. 

Although pica can be a source of shame or embarrassment for some people, being honest during your medical assessment can help your healthcare providers understand how to best manage the condition.

2. Talk therapy and behavior interventions 

Talk therapy can help you identify and change harmful thoughts and habits, including pica behaviors. Working with a therapist offers people a chance to address underlying triggers or causes of pica, like stress, anxiety, or trauma. 

Through behavioral therapy techniques like cognitive behavioral therapy (CBT), you can learn to understand your distressing emotions, manage your pica urges, and develop healthier habits and coping strategies. Therapists may also use mild aversion therapy, which discourages unwanted pica behaviors while rewarding healthy eating habits.

3. Dietary counseling and management

Similar to other eating disorders, pica treatment typically involves dietary counseling and support. By working with a registered dietitian or nutritionist, you’ll learn to understand specific pica cravings, address nutrient deficiencies, and make healthier food choices. 

4. Medical interventions 

Depending on a person’s specific cravings, pica behaviors can cause serious health conditions that require medical interventions. For example, some people require dental work to repair damage to their teeth. And other people need antibiotics to treat infections from ingesting harmful items. In some cases, people may benefit from medication to help manage mental health symptoms and reduce cravings for non-food items.

5. Supportive family and friends 

Treating pica may require support from trusted friends, family, and caregivers. To start, consider asking loved ones for help removing problematic items so that you’re not tempted to consume them. Having a strong support system is also essential for learning to manage or overcome any underlying mental or physical health problems. 

Find care with Rula

Treating an eating disorder like pica requires access to the right resources and support, starting with a qualified mental health professional. 

Rula can help you find a therapist who takes your insurance so that you can get the support you need. With Rula’s easy-to-use therapist-matching program, it’s possible to find a therapist who understands your needs so that you can begin treatment as early as this week. 

And if medication management is part of your treatment plan, we can connect you with a psychiatrist to find the right solution for you. Whether it’s pica, binge eating disorder, bulimia nervosa, or another condition, Rula is here to help connect you with coordinated, comprehensive care.

Find a therapist with Rula