We’ve all heard and even joked about the peculiar pregnancy cravings for unusual foods, but have you ever encountered instances where cravings extend beyond foods to include non-food items? This behaviour is known as pica and, according to studies, is more common than one might think. While it’s often associated with pregnant individuals, it can affect a diverse range of people and, in some cases, escalate into a dangerous eating disorder.
What is Pica?
Pica is a medical condition characterised by the persistent consumption of non-nutritive, non-food substances over a period of at least one month. People with pica may eat items such as;
Pica can occur in children, adolescents and adults and is associated with various factors, including developmental disabilities and possibly autism, but a comprehensive assessment is usually needed to determine the underlying causes. There is typically no aversion to food in general.
Is PICA classed as an eating disorder?
The DSM-5 lists pica as an eating disorder and can be diagnosed through the following criteria;
- Persistent eating of nonnutritive, nonfood substances over a period of at least 1 month.
- The eating of nonnutritive, nonfood substances is inappropriate to the developmental
level of the individual. - The eating behaviour is not part of a culturally supported or socially normative practice.
- If the eating behaviour occurs in the context of another mental disorder (e.g., intellectual
disability [intellectual developmental disorder], autism spectrum disorder, schizophrenia)
or medical condition (including pregnancy), it is sufficiently severe to warrant additional
clinical attention.
Disclaimer
It’s important to note that pica can be associated with other mental health conditions, medical conditions, or developmental disorders and a comprehensive assessment is usually needed to determine the underlying causes and appropriate treatment. If you or someone you know may be experiencing symptoms of pica, it is advisable to seek professional help from a mental health or healthcare provider.
Are there different types of Pica?
There are different types of pica based on the substances consumed. Although there is no mention of these types in the DSM-5, this classification system can help medical professionals identify and comment upon a person’s specific traits of Pica. Here are some common types:
Geophagia
This involves the consumption of earth or soil. People with geophagia may eat dirt, clay, or other earthy substances.
This type involves the compulsive consumption of ice. Individuals with pagophagia may have a strong craving for and eat large quantities of ice.
Amylophagia
Amylophagia refers to the consumption of starch, such as laundry starch or raw grains like rice and uncooked pasta.
This type involves the consumption of hair. People with trichophagia may eat their own hair or hair from other sources.
Xylophagia
Xylophagia is the consumption of wood. Individuals with this type of pica may eat pieces of wood or paper.
This involves the consumption of metal objects. Individuals with metallophagia may eat items like coins, nails, or other metal objects.
Coprophagia
Coprophagia involves the consumption of faeces. This behaviour may be seen in some individuals, including certain animals.
Some individuals with pica may eat plastic or rubber items, such as balloons or erasers.
What are the causes of Pica?
The causes of pica can be complex and multifaceted, and they may include a combination of biological, psychological and environmental factors. Some causes are speculated to be due to nutritional deficiencies, with pica often linked to shortages in certain nutrients such as iron, zinc, or other minerals. The body may crave non-food items in an attempt to obtain the missing nutrients.
During pregnancy, nutrient deficiencies can lead to cravings for substances like ice, clay, or starch, particularly in iron or other minerals. These cravings are often attributed to the body’s attempt to fulfil specific nutrient needs during pregnancy.
Additionally, pica may be more prevalent in individuals with developmental disorders, such as autism spectrum disorder or intellectual disabilities.
Mental health conditions could also play a role. Certain studies have suggested an overlap between those with OCD, schizophrenia and pica, although more research is needed in this area. Pica can also be associated with trichotillomania (hair pulling disorder) and excoriation (skin-picking) disorder.
Family or environmental factors could influence pica, such as a lack of supervision, neglect, or exposure to family members with similar behaviours. Stressful or chaotic living conditions could also contribute to the development of pica. Moreover, cultural and social factors may come into play, as in some cultures, certain non-food substances are considered acceptable or even consumed for medicinal or cultural reasons. However, Pica refers to the consumption of non-nutritive items in a way that is not culturally or developmentally appropriate.
Is pica dangerous?
Pica can be extremely dangerous based on the person’s choice of what to ingest. The more severe the object, the worse it can be on the body. A person with Pica runs the risk of possibly being exposed to the following risk factors:
General health risks
Consuming non-food items can lead to various health complications depending on the substance ingested. For example, eating items like metal, glass, or chemicals can cause damage to the gastrointestinal tract, blockages, toxicity, or other serious health issues.
Nutritional deficiencies
Since the non-food items do not provide any nutritional value, individuals with Pica may be at risk of malnutrition and nutrient deficiencies. This is particularly concerning if the disorder persists over an extended period.
Infections
Ingesting items such as dirt or contaminated objects can increase the risk of infections, which may affect the gastrointestinal system or other organs.
Obstruction and choking hazard
Swallowing non-food items, especially those that are not easily digestible, can lead to gastrointestinal obstructions. In addition, some items may pose a choking hazard, especially if they are not intended for consumption.
Dental issues
Chewing on hard or abrasive substances can result in dental problems, including damage to the teeth and gums.
How is Pica treated?
The treatment of pica syndrome typically involves a comprehensive approach that combines medical interventions with behavioural therapies to manage the condition effectively. Key strategies in treating pica include:
- Medical interventions: Addressing the physical health issues resulting from pica is a priority. This may involve surgical procedures or medication to manage the consequences of ingesting non-food items.
- Nutritional counselling: Nutritional counselling is often necessary to address deficiencies and guide individuals toward a balanced diet. This can help reduce cravings for non-food items.
- Occupational therapy: Engagement in occupational therapy is crucial for individuals to develop the skills necessary for daily life activities, steering away from the maladaptive coping mechanism of consuming non-edible objects.
- Cognitive Behavioural Therapy (CBT): CBT is utilised to explore the emotional and psychological factors driving pica. It helps individuals develop healthier coping strategies and reshape unhelpful thought patterns.
- Dialectical Behavioural Therapy (DBT): DBT assists individuals in gaining control over intense emotions and reducing self-harming behaviours associated with PICA. It encourages effective impulse management through behavioural therapy and mindfulness strategies.
- Psychoeducation: Implementing psychoeducation educates individuals and their families about the disorder, provides insights into various treatment approaches, actively combats the stigma associated with the condition and promotes collaborative involvement in the treatment plan.
- Art and music therapy: These therapies aim to reduce anxiety and encourage emotional expression, potentially addressing triggers for PICA through creative and non-verbal approaches.
- Mindfulness and meditation: Meditation and mindfulness techniques can be beneficial in helping individuals stay grounded, encouraging a deeper understanding of personal triggers and encouraging self-control.
What are the next steps?
If you or your loved ones are unsure whether you’re dealing with pica or any other health issue, it’s crucial to reach out to healthcare professionals for proper guidance.
Self-diagnosis is not a reliable option, as various factors need to be considered for an accurate assessment. Healthcare professionals can conduct thorough testing and evaluations to determine the presence of pica or any other related conditions.
Rehabilitation centres can also be valuable resources for those dealing with pica. They offer professional counselling and educational support to help individuals combat and overcome this condition. Seeking help from experts ensures a comprehensive approach to understanding and managing the challenges associated with pica.
Remember, you don’t have to face these concerns alone. Taking the step to consult healthcare professionals is an essential first move towards better understanding and addressing the situation. They can provide the necessary guidance and support to help you or your loved ones navigate through any potential health issues.
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