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Published On: Feb 20, 2024|Categories: Eating Disorder Information|

What is Pica Eating Disorder?

The DSM-5 defines pica as the consumption of substances that are not food and have no nutritional value over at least one month. Pica eating disorder symptoms range from harmless behaviors such as eating ice, officially called pagophagia, to wildly hazardous consumption patterns such as consuming toxic substances, large non-food solids, or even feces. Pica eating disorder is most often observed in pregnant women and young children. Victims of abuse or neglect, and children with certain learning disabilities may also present symptoms of pica. 

People suffering from pica may seek to compulsively consume the following substances:

  • Chalk
  • Dirt
  • Coffee grounds
  • Paper
  • Soap
  • Baby powder
  • Laundry detergent
  • Eggshells
  • Charcoal 
  • Hair

Who does Pica Eating Disorder Affect? 

Pica is most often seen in pregnant women and children over the age of two.  Pica eating disorder in adults is far less frequent and is most commonly linked to a mental or psychological health condition such as:

  • Autism Spectrum Disorder
  • Schizophrenia
  • Obsessive Compulsive Disorder (OCD)
  • Excoriation (compulsive skin-picking)
  • Trichotillomania (compulsive hair-pulling)

There are some cases in which eating, or attempted eating, is not considered to be disordered. For example, a baby’s behavior of putting non-food substances in their mouth would not qualify as a form of pica. This is a normal phase of a child’s development, and how they explore the world. The behavior should disappear as the child matures. For this reason, pica cannot be diagnosed until the child is at least two years old. 

Pica is also not diagnosed if the person’s alternative consumption patterns are considered socially acceptable; for example, eating dirt or clay as a part of a cultural ritual.

Treatments for Pica Eating Disorder

Treatment practices for pica vary based on the age, mental and physical condition of the person in question. Due to the physical and psychological complexities often presented with this disorder, a team of specialists is usually needed to collaborate on a treatment plan that addresses all aspects. Nutritionists, medical doctors and psychotherapists may all be included in this assessment phase. 

Pregnant women generally cease to struggle with these behaviors and nonfood cravings after they give birth, so no further treatment is needed. Similarly, many children outgrow the behavior as they get older. In either case, however, it is crucial to exercise prudent supervision and implement appropriate therapeutic methods to ensure the safety of the individual. 

Pica as a Symptom of Nutritional Deficiencies

In some cases, pica may be a symptom of a greater medical problem that needs to be addressed. For example, a deficiency in vitamins or minerals can cause ferocious and bizarre cravings as the body seeks to meet a nutritional need through creative means. This can happen especially in the case of calcium, zinc or iron deficiency, which is connected with chalk, dirt or clay ingestion. This phenomenon is particularly observable in cases of extreme hunger or malnutrition. 

In the event of an underlying medical issue or nutritional imbalance, treatment would begin with a thorough evaluation of the patient’s physical health. Testing modalities could include but are not limited to:

  • Blood panels
  • Scans or X-rays of the stomach and intestines
  • Urine tests
  • Stool tests
  • Parasite testing
  • Saliva tests. 

The results of such testing can provide a roadmap for treating the root of the underlying problem. Nutritional supplements, medications or antibiotics may be necessary to return the body to proper balance in hopes of eliminating the hazardous and compulsive eating habits. It may also be helpful to consult a nutritionist to make a personalized plan to achieve full health and healing.

Pica as a Symptom of a Psychological Issue

While pica often has roots in medical or nutritional conditions, the emotional and psychological health of a person can also be a contributing factor to the disorder. Psychological trauma, neglect or abuse could also be that which lies beneath the surface of pica eating disorder. Children may ingest dangerous objects or substances to attract attention from distracted parents. Abnormal eating patterns can also be used as a coping mechanism for people struggling to overcome traumatic events, as it creates a dopamine release when the compulsion is gratified.

Pica is sometimes found in individuals with intellectual or psychological disabilities such as Autism Spectrum Disorder, schizophrenia and Obsessive Compulsive Disorder. Treatment in these cases may be far more complex and will rely heavily on treating the co-occurring disorders via medication, therapy or other various modalities as directed by a qualified professional. 

Safety-proofing the environment as well as providing supervision to affected people is necessary to prevent severe medical crises. Treatment measures may include:

  • Removing dangerous or toxic substances from the home.
  • Providing education to family and friends who will be involved in the individual’s healing journey.
  • Behavior modification strategies, such as praising the person for eating healthy foods.
  • Emotional support to buffer any negative reactions to the absence of the desired non-food substance.

While a pica diagnosis can be daunting, some studies on pica eating disorder in Autistic people report rates of 90-100 percent improvement through proper treatment. Further research must be done to determine the intervention success rate in adults battling pica.

Find Help for Pica Today

Pica’s eating disorder can be confusing and overwhelming to try to address on your own. If you or a loved one are struggling with this condition, our team of professionals at Seeds of Hope is here for you. Contact us online, or call 610-644-6464 to start your healing journey today.

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