PICA: A Lesser Known, Highly Disturbing Eating Disorder

Contributor: Dr. Kim Dennis

A hundred years ago, an eating disorder would be an unfathomable concept. Today, most people are aware of anorexia and bulimia, probably enough to identify that the former involves starvation, while the latter has to do with eating a great deal of food and then purging.

Much less is known about binge eating disorder, which coincidently is the most common eating disorder in the United States.

A Baffling Disorder

Most eating disorders are anathema to those who do not have one, but certain food-related illnesses are particularly alarming and baffling to the public at large. PICA is certainly one of them.

This is typically defined as the persistent ingestion of non-nutritive substances for at least one month at an age for which this behavior is developmentally inappropriate. In other words, it is the ingestation of items or substances that are not food.

The list includes:

• Dirt
• Sand
• Stones
• Pebbles
• Hair
• Feces
• Lead
• Laundry starch
• Vinyl gloves
• Plastic
• Pencil erasers
• Fingernails
• Paper
• Paint chips
• Coal
• Chalk
• Wood
• Plaster
• Light bulbs
• Needles
• String
• Cigarette butts
• Wire
• Burnt matches

Causes of PICA Behavior

Some small children routinely ingest non-edible items out of boredom or simply due to the enjoyment of putting things into their mouths. This caused extreme concern in the decades before lead-based paint was taken off the market.

Children would consume paint chips and suffer a variety of negative medical and cognitive consequences. Another population somewhat at risk is pregnant women. This is particularly the case in the first trimester of pregnancy.

Although medical professionals and researchers are confounded as to what inspires the urge, women can suddenly crave such items as coffee grounds or laundry detergent.

Common Reasons for PICA Behavior

In the general population, it is thought that the most common reason for PICA behavior is anemia or the absence or lack of important minerals, such as iron or zinc. Those in the medical profession also believe that some engage in this activity simply because they like the taste, texture or smell of the things they consume.

Interestingly, the act is actually reinforcing in that ongoing consumption of these items ultimately activates the reward circuit in the brain, causing the individual to crave the substance even more.

The Prevalence of PICA

The prevalence of PICA activity is unknown since it often goes unreported. However, it is most commonly diagnosed in women and children, especially those with mental and developmental delays, particularly those with schizophrenia and autism.

Considering the unusual items that might be consumed, it is no surprise that PICA is viewed as an extremely dangerous behavior. Possible complications include:

Poisoning

Items, such as paint chips, may contain lead or other toxic substances. Consuming these substances can poison the individual. In a child, this toxic environment can translate into learning disabilities, brain damage or death.

Dental Damage

Permanent harm to the teeth is not unusual. Human beings are meant to eat real food, not rocks and stones; broken teeth often result from this behavior.

Nutritional Deficiencies

If a person is too involved with unhealthy consumption, they risk negating the benefit of healthy food; this can result in deficiencies in the nutrients the body needs to maintain health.

Physical Damage to the Body

Eating objects that cannot be digested, such as plastic or metal, can cause constipation or blockages in the digestive tract, including the intestines and bowels. Even worse, hard or sharp objects, such as glass or needles, can perforate the lining of the intestines.

Dangerous Infection

Bacteria or parasites from dirt or other objects can cause infections; some can damage the kidneys or liver.

Treatment

The first step is to obtain a medical evaluation if PICA is suspected. This may include an assessment for possible anemia, intestinal blockages, or potential toxicity from ingested substances.

A complete medical history should be taken as well as a physical exam. X-rays can reveal items or blockages in the intestinal tract, while blood tests can determine possible anemia, toxins and other substances in the blood.

PICA, like most eating disorders, rarely resolves on its own. Treatment is recommended. If you, or someone you know, routinely eats objects or substances that are not food, please consult with a health care provider.

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Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 12th, 2014
Published on EatingDisorderHope.com