Pica: Not Your Usual Eating Disorder

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. 

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 have pica, this eating disorder can develop in 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 for pica.

What we do know is that pica can develop during pregnancy, and some researchers speculate that nutritional deficiencies are behind the compulsion to eat non-food items. 

What Is Pica, And What Are The Dangers of This Eating Disorder?

The eating disorder pica gets its name from "pica pica", the Latin word for magpie. Magpies are birds that eat almost anything and are known for their compulsion to take shiny things to their nests. People who suffer from the eating disorder pica crave eat any non-food items compulsively, but the ones listed above are some of the more commonly chosen things. 

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)

• The symptoms and eating habits 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 that can range from from damaged tooth enamel to metabolic changes. Because of the complications associated with consuming ice on a regular basis, the compulsive eating of ice cubes counts as pica as well. 

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 bowel perforations, and eating items contaminated with bacteria, like soil, can result in serious infections.

Pica cravings can be invasive enough to interfere with the consumption of actual food as well — or to put it in plain English, 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.