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What do sponge, clay, soil, paint, soap, chalk, cigarette ash and paper have in common? Not much, at first sight, but look closer. None of these things are food items, yet there are people who consume them compulsively.
When you hear the umbrella term "eating disorders", your mind is bound to redirect you to anorexia and bulimia. These two are, along with binge eating, closely linked to depression. Eating disorders have the highest mortality rate of any mental illness.
Many patients with eating disorders place their lives at risk by starving themselves. At the other end of the spectrum, you have people so obese that their bodies could just stop at any time. Pica falls into a whole other category though. Pica is not your usual eating disorder — it doesn't have anything to do with eating too little or too much, but rather with eating things that aren't food at all.
Who would want to eat things that aren't food? You must be pretty crazy to have cravings for cigarette ash or sponge, right? While it's true that a relatively large percentage institutionalized populations has pica, it can happen to anyone. The true prevalence of this eating disorder in society at large isn't known, perhaps because folks who have it are afraid to seek medical help.
What we do know is that pica can happen during pregnancy, and some speculate that nutritional deficiencies are behind the compulsion to eat non-food items.
What Is Pica, And What Are The Dangers?
The eating disorder pica gets its name from "pica pica", the Latin word for magpie. Magpies eat almost anything and are known for their compulsion to take shiny things to their nests. People who suffer from the pica crave eat any non-food items compulsively, but the ones listed above are some of the more commonly chosen things.
Others? Feces, believe it or not. Then there's starch, glass, sand, pebbles, hair, hair, wool, and wood.
The latest version of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, has the following diagnostic criteria for pica:
- A person must suffer from the compulsive eating of non-food items for at least one month
- This habit has to be inappropriate for the developmental level of the individual (your orally-fixated infant does not have pica)
- The eating disorder can't be part of a cultural or social practice (in some parts of southern Africa, people eat soft stones as a snack)
- It must be severe enough to warrant clinical attention if it happens in people with mental disorders like autism spectrum disorder or physical conditions like pregnancy
Quite a few people apparently crave ice cubes and give into that craving. Though ice cubes are made from water, which is the most essential food item out there, its temperature can cause problems from damaged tooth enamel to metabolic changes. Because of this, the compulsive eating of ice cubes counts as pica.
Eating paint can lead to lead poisoning, and eating items that can't possibly be digested can cause constipation and bowel obstruction. Eating sharp items can lead to perforations, and eating items contaminated with bacteria, like soil, can result in infections.
Pica cravings can be invasive enough to interfere with the consumption of food as well — if your stomach is full of sponge, you're not going to be hungry. Though some people speculate that nutritional deficiencies can be the reason someone develops pica (iron deficiency = craving for scrap metal?), pica can cause nutritional deficiencies if it keeps a patient away from normal food.
What are the risk factors for pica? And how can the condition be treated? More about that on the next page.