We all are prone to the occasional craving, particularly when we are over-tired or experiencing hormonal changes or stress. According to Harvard T.H. Chan, these cravings are usually for foods that are sugary, salty, fatty, or all three. But if you are experiencing strong cravings for non-food items, like paper and dirt, the explanation might be an eating disorder called pica.
What is Pica?
According to NEDA, pica involves eating items that are not typically thought of as food and that do not contain significant nutritional value. Common cravings in those who are diagnosed with pica include the following:
- Paper
- Soap
- Cloth
- Hair
- String
- Ice
- Soil
- Chalk
- Talcum powder
- Paint
- Gum
- Metal
- Pebbles
- Charcoal
- Ash
- Clay
- Starch
What Are the Warning Signs for Pica?
- The persistent eating, over a period of at least one month, of substances that are not food and do not provide nutritional value.
- The ingestion of the substance(s) is not a part of culturally supported or socially normative practice (e.g., some cultures promote eating clay as part of a medicinal practice).
- The eating of these substances must be developmentally inappropriate. For example, in children under two years of age, mouthing objects—or putting small objects in their mouth—is a normal part of development, allowing the child to explore their senses. Therefore, children under two years old should not be diagnosed with pica.
How is Pica Diagnosed?
There are no laboratory tests available to test for pica, so a diagnosis must be made by a doctor from a clinical history of the patient. The NEDA states that when diagnosing pica, a doctor should also give the patient tests for anemia, potential intestinal blockages, and toxic side effects of substances consumed (i.e., lead in paint, bacteria or parasites from dirt).
Risk Factors
According to the NEDA, pica can occur with other mental health disorders associated with impaired functioning, such as intellectual disability, autism spectrum disorder, and schizophrenia. The disorder can also be caused by nutritional deficiencies, like iron-deficiency anemia and malnutrition. Additionally, pica is seen more frequently in pregnant women and people living in developing countries; in a 2020 study of 286 pregnant women in Ghana, prevalence of pica was reported to be 47.5%.
How is Pica Treated?
In many cases, behaviors associated with pica disappear after vitamin deficiencies are addressed. If the behaviors are not caused by a deficiency, behavioral interventions are available.
For more information on pica, visit www.nationaleatingdisorders.org.
