Pica

People with pica may experience certain signs and symptoms after consuming non-food items. The symptoms can vary depending on the specific non-food substances they consume. In some cases, pica might not be diagnosed until symptoms of serious health problems occur. Some potential symptoms of pica may include:

• Nausea
• Pain or abdominal cramping in the stomach
• Constipation
• Diarrhea
• Fatigue

Individuals with pica often eat regular nutrient-filled foods in addition to ingesting non-food items. However, some of those affected by the disorder are nutritionally malnourished.

Other signs of pica might include:

• Dental problems, such as worn or broken teeth
• Stomachaches or digestive issues
• Bacterial or parasitic infestations, with symptoms such as fever, cough, or visual problems
• Lead poisoning, with symptoms such as headaches, seizures, and lethargy
• Serious health complications 

In some cases, pica may lead to more serious health complications. For example, ingesting objects that cannot be digested, like stones, can cause constipation or blockages in the digestive tract, including the intestines and bowels. Consuming hard or sharp objects could also lead to internal injuries or ulcers.

Pica in children  

While the symptoms of pica can be distressing, they may not be evident in children. Parents or caregivers can be vigilant in monitoring their children's eating habits and any unusual behaviors or cravings. Some warning signs in children might include:

• Frequently putting non-food items in their mouth
• Expressing unusual cravings or strong desires for strange substances
• A history of eating non-food items in the past

Diagnosis 

As an eating disorder in which a person eats things not usually considered food, pica can be challenging to diagnose, as individuals with pica may not readily share their unusual cravings with other people. Therefore, healthcare professionals, family members, and caregivers can be aware of the signs and symptoms of the disorder to identify it early and seek appropriate treatments.

The causes of pica are not fully understood, but several factors may contribute to its development. One common risk factor is experiencing psychological trauma or stress. These situations may lead to pica as a coping mechanism. In addition, family challenges and parental neglect can be risk factors for the development of the disorder.

In some cases, pregnancy may cause pica. Pregnant women are more likely to develop this condition, possibly due to hormonal changes or nutritional deficiencies. In some instances, pica is seen as a symptom of iron deficiency anemia during pregnancy. 

Pica is also common among young children and individuals with developmental disabilities like autism spectrum disorder (ASD).² Other potential risk factors may include:

• Cultural factors
• Mental health disorders
• Epilepsy
• Low socioeconomic status

Pica can sometimes be a learned behavior, especially in children who mimic the eating habits of those around them. In regions where pica is socially acceptable or encouraged, individuals may be more likely to engage in this behavior.

There is no one-size-fits-all explanation for pica, and its causes may vary from one person to another. The craving for non-nutritive items may often be the body’s response to a lack of proper nutrition. Some individuals may experience a combination of risk factors, while others may have specific underlying challenges contributing to their condition.

Pica treatment goals may include managing the underlying cause of the eating disorder and preventing individuals from eating non-food items. The treatment plan often involves therapy, medication, and self-care methods.

Medication

While no specific medication directly treats pica, medications may be prescribed to treat underlying causes or related symptoms. For example, a doctor might prescribe the following: 

• Iron supplements: Pica has been associated with iron deficiency. If an individual is found to have iron deficiency, supplementation with iron may resolve the deficiency, which may, in turn, reduce the craving for non-food items.
• Other nutrient supplements: If other deficiencies are identified, those may also be supplemented, such as zinc. Some supplements may be used to target symptoms like lead poisoning, which can occur for some people with pica.

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis. 

Other treatment options for pica

In some cases, additional interventions may be beneficial to manage pica. These options may include the following: 

• Dietary modifications: Fixing nutritional deficiencies may reduce pica symptoms. A registered dietitian or nutritionist can help you determine if any dietary changes would be beneficial. 
• Environmental changes: Ensuring the environment is free from easily accessible non-food items may minimize pica risks. Environmental changes may involve using childproof locks on cabinets or removing specific items from the home.

Self-care methods

Alongside professional treatments, self-care strategies may help individuals with pica better manage their symptoms and improve their well-being. Self-care strategies might involve engaging in activities like yoga, meditation, or physical exercise to reduce stress, which might contribute to pica symptoms.

Individuals experiencing pica can consult their healthcare provider before beginning any medication regimen. A healthcare provider can evaluate an individual’s health to determine the most appropriate and safe treatment.

There are various resources available to support individuals living with pica. Therapy may be an effective option for managing the condition and underlying compulsive behaviors. One such resource is online therapy through platforms like BetterHelp, which offer phone, video, or live chat sessions that can be tailored to an individual's treatment goals and preferences. 

In addition to therapy, there are mental health organizations and support groups that focus on supporting those with pica and related eating disorders. The National Eating Disorders Association offers information on pica, its causes, treatments, and resources for those seeking help. The Association of Anorexia Nervosa and Associated Disorders (ANAD) and Eating Disorder Hope (EDH) are other organizations that provide education, recovery tools, and community support for eating disorders like pica. 

Individuals and loved ones may find comfort in knowing support is available. With these resources, individuals living with pica can take proactive steps toward improving their condition and reducing the disorder’s effects on their lives.

Please see our Get Help Now page for more immediate resources.

Researchers have conducted studies to better understand pica and develop effective treatments. One review article examined the link between pica and iron deficiency anemia. With data from 20 studies, researchers found that identifying symptoms of pica early allowed healthcare providers to treat iron deficiency more effectively. After the iron deficiency was treated, the symptoms of pica resolved. The study highlights how important it can be to identify and understand pica symptoms for improved recovery from iron deficiency.

One review analyzed different behavior-based treatments for pica. The review, which examined 30 different studies, found that specific methods, such as rewards for appropriate behavior, discrimination training, physical restraint, and time-out, successfully reduced pica symptoms. The study suggests starting with less limiting techniques and adding more restrictive ones if needed.

Below are several statistics on pica:

• The prevalence of pica varies among different groups of children with autism spectrum disorder (ASD) and intellectual disability (ID).⁴ One study found the rate was around 28% in preschool-aged children with autism spectrum disorder (ASD) and intellectual disability (ID), around 14% in children with ASD but without ID, and around 10% in children with ID but without ASD or autism symptoms.
• Pica is highly associated with sickle cell disease and younger age. Recent meta-analysis data shows that approximately 39.5% of children with sickle cell disease show pica behavior.
• The prevalence of pica in children in one study was approximately 3.7%. This figure shows that pica is more prevalent among children than commonly realized, underscoring the benefit of increased awareness and early intervention strategies.
• The prevalence of pica in pregnant women worldwide is high. One meta-analysis found that around 27.8% of women who are pregnant experience pica. 
• CBT is often considered one of the most effective treatments for eating disorders like pica, as it is highly individualized and adaptable.