Pica is a disorder where people eat non-food items such as hair, dirt, and paint chips. Pica can affect people of all ages and genders. Pregnant individuals should only be diagnosed with pica if their cravings lead to eating nonfood items and pose a potential medical risk. The number of people affected by pica is not clear. Pica was officially recognized as an eating disorder in 2013, but there is limited research on it. Because of this lack of research, the rates of the disorder vary. One study found that around 1.1% of adults have recurrent pica behaviors, while another study found that 5% of youth aged 7 to 14 experience the same behaviors. A different study showed that 27.8% of pregnant women worldwide exhibit pica behaviors, with higher rates in developing countries. This is likely because of increased food insecurity and malnutrition, which are believed to contribute to the development of pica.

Typical signs of pica include ongoing consumption of non-food substances for more than a month. The ingestion of these substances is not considered a usual practice in a specific culture. Common substances ingested vary depending on age and availability and include paper, soap, cloth, hair, and more. Consuming non-food items must be inappropriate for their age. Children under two naturally explore through mouthing objects, but this should not be mistaken for pica. Usually, individuals with pica are not opposed to eating regular food.

Risk factors for Pica include co-occurring mental health disorders like intellectual disability, autism spectrum disorder, and schizophrenia. Iron-deficiency anemia, malnutrition, and pregnancy are common causes of Pica, indicating a need for nutrient correction. A medical evaluation is necessary to determine the severity of the behavior and if clinical care is needed. Lack of supervision in children and family history of Pica are also risk factors.

Pica can have severe health consequences, including:
Poisoning, especially lead poisoning, can cause neurological symptoms like irritability, lethargy, headaches, loss of bodily control, seizures, and even brain damage.
Infection or parasitic infestations, which can lead to fever, malaise, coughing, visual problems, and inflammation of the heart or brain.
Gastrointestinal problems like constipation, intestinal obstruction, ulcers, or perforations.
Dental issues such as severe tooth damage or gum abrasions.

How is pica diagnosed and treated?
The diagnosis of pica is based on the patient’s clinical history rather than laboratory tests. Tests for anemia, intestinal blockages, and toxic effects of consumed substances should also be conducted.

The primary treatment for pica involves fixing mineral or nutrient deficiencies. Correcting deficiencies can often make concerning eating behaviors go away. If malnutrition isn’t the cause or behaviors persist after nutritional treatment, various behavioral interventions are an option. Scientists in the autism community have created multiple effective interventions for individuals with developmental disabilities. These interventions include redirecting attention from the desired object and rewarding them for putting down or getting rid of the non-food item.

Pica can be linked to various conditions such as intellectual disability, schizophrenia, autism spectrum disorder, trichotillomania, excoriation disorder, obsessive-compulsive disorder, and sickle cell disease. Additionally, recent research suggests that pica can also be associated with depression, anxiety, other eating disorders, and negative body image. Early detection and treatment of pica are crucial due to potential health risks. Since specialists in pica treatment are limited, if you or someone you know shows concerning pica-related behaviors, consult a primary care doctor or pediatrician promptly. If harmful ingestion has occurred, seek immediate medical help.

Sources:
https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/pica