Pica is an eating disorder that causes people to eat non-food items that offer no nutritional value, like paint, dirt, and soap. They typically have no control over this behavior.
Anyone can show pica behaviors, but the condition is most commonly seen in young children, during pregnancy, and in people with intellectual disabilities.
Treating pica typically requires a combination of medical and behavioral interventions designed to address any underlying causes, as well as the mental and physical health effects.
Eating disorders are complex conditions that cause severe disturbances in eating habits and food behaviors. While many eating disorders involve eating too much or too little food, pica is different. It’s an eating disorder that involves eating non-food items that have no nutritional value.
People with pica may compulsively eat items like paper, paint, string, soap, or dirt. Anyone can develop pica, but it’s most common in young children, people who are pregnant, and people with intellectual disabilities. While some behaviors may seem harmless, pica can sometimes lead to serious health complications.
Learning to recognize the signs and symptoms of pica can help you seek the right treatment for yourself or a loved one.
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Signs and symptoms 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
How pica is diagnosed
If you think you or a loved one may have pica, the first step is a professional evaluation. A mental health professional will ask questions about eating habits, medical history, and any non-food items the person has been consuming.
To diagnose pica, the behavior must continue for at least one month and be inappropriate for a person’s age or developmental stage. The mental health professional will also check that the behavior isn’t part of a cultural or religious practice.
In some cases, medical tests may be recommended. These tests can check for complications like nutritional deficiencies, poisoning, or digestive problems. Once a diagnosis is confirmed, a provider can recommend the right treatment plan.
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.
Possible triggers of pica
Even when someone has risk factors for pica, certain situations can trigger the behavior. Triggers can vary from person to person and may be linked to physical, emotional, or environmental factors.
Common triggers of pica may include:
Stress or anxiety: Some people turn to pica behaviors when they feel overwhelmed or emotionally distressed.
Pregnancy-related cravings: Hormonal and nutritional changes during pregnancy may lead to unusual cravings.
Developmental or sensory needs: Children or people with developmental conditions may explore or seek certain textures through non-food items.
Environmental exposure: Being around certain materials frequently may increase the urge to eat them.
Boredom or lack of stimulation: Some people engage in pica behaviors when they feel understimulated or need sensory input.
Understanding possible triggers can help guide treatment. Identifying what tends to trigger the behavior may make it easier to reduce cravings and build healthier coping strategies.
Treatment options 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.
How to stop pica-related habits
If you or a loved one faces challenges with pica behaviors, professional treatment is often important. However, there are also small steps that may help reduce urges and support healthier habits alongside medical care.
Some strategies that may help include:
Replace the behavior with a safer alternative. When an urge appears, try redirecting it to another activity. Chewing sugar-free gum, drinking water, or engaging in a short task can help shift your focus.
Reduce access to non-food items. Removing or limiting access to commonly consumed items can reduce temptation. This may involve changing your environment or asking others to help keep certain materials out of reach.
Create structure in your day. Having regular meals, snacks, and activities can reduce boredom and help stabilize eating habits.
Practice stress management. Techniques like deep breathing, mindfulness, or short walks can help regulate emotions that might trigger pica urges.
Self-help strategies can be helpful, but they aren’t a replacement for professional care. If pica behaviors continue or lead to health concerns, working with a healthcare provider or therapist can help you find the safest and most effective treatment plan.
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In my experience, tracking when urges happen can help people better understand their patterns. This awareness can make it easier to develop practical coping strategies with the support of a healthcare provider.
Brandy Chalmers, LPC
Clinical reviewer
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 soon as tomorrow.
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.
Alex Bachert
Alex Bachert is a freelance copywriter and mental health advocate. Since earning her masters degree in public health, she has focused her career on creating informative content that empowers people to prioritize their health and well-being. Alex has partnered with organizations like Ro, WellTheory, and Firsthand, and her work has been recognized by the Digital Health Association.
When she’s not writing about mental health, Alex is usually playing pickleball, meeting with her local board of health, or enjoying time with her three kids.
Shakirra Jones LMHC, LPC, NCC
Shakirra Jones is a Licensed Professional Counselor in Georgia. She is a graduate of Tuskegee University and the Chicago School of Professional Psychology. She has previously worked in community mental health, college counseling and substance use recovery.
She is passionate about creating safe, supportive spaces for people from communities that are historically underserved.
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