Pica - Eating Disorder

The term Pica originates from the Latin word for magpie, a bird that is reputed because of their unusual eating behaviors where they are known to eat almost anything. It is characterized by an appetite for substances largely non-nutritive. For these actions to be considered Pica, they must persist for more than one month at an age where eating such objects is considered developmentally inappropriate. There are different variations of Pica, as it can be from a cultural tradition, acquired taste or a neurological mechanism such as an iron deficiency, or chemical imbalance. It can lead to intoxication in children which can result in an impairment in both physical and mental development.

In addition, it can also lead to surgical emergencies due to an intestinal obstruction as well as more subtle symptoms such as nutritional deficiencies and parasitosis. Stressors such as maternal deprivation, family issues, parental neglect, pregnancy, poverty, and a disorganized family structure are strongly linked to Pica.

This non-food cravings eating disorder can be found in 10 percent to 32 percent of children between the ages of 1 and 6, according to the National Library of Medicine. These youngsters will eat paint, plaster, string, hair, and cloth. Older children consume anything from animal droppings, sand, and insects to leaves, pebbles, and cigarette butts. Teens and adults most commonly eat clay or soil, though people have been found to ingest lead, laundry starch, plastic, pencil erasers, ice, fingernails, paper, coal, chalk, wood, plaster, light bulbs, needles, string, and wire.

Pica is more commonly seen in women and children, where it affects people of all ages in these subgroups. Particularly it is seen in pregnant women, small children, and those with developmental disabilities such as autism. For children with autism, suffering from Pica disorder has seemed to be even more dangerous. Children eating painted plaster containing lead may suffer brain damage from lead poisoning. There is a similar risk from eating dirt near roads that existed prior to the phaseout of tetra-ethyl lead in petrol (in some countries) or prior to the cessation of the use of contaminated oil to settle dust. In addition to poisoning, there is also a much greater risk of gastro-intestinal obstruction or tearing in the stomach. Another risk of dirt-eating is the possible ingestion of animal feces and accompanying parasites.

Certain tests can be a good start toward determining treatment, including hemoglobin to check for anemia, lead levels if paint or objects coated with lead paint have been consumed, and gastrointestinal tests to rule out infection in the case of soil or animal waste being ingested. As a first step, treatment should replace missing nutrients if applicable and address any other health issues. A multi-faceted approach including developmental, behavioral, and environmental therapy along with family education is often recommended. Sometimes treatment can succeed when the individual experiences negative consequences after eating a non-food substance, and then gets positive reinforcement for consuming proper food.

Ultimately the prognosis depends on a variety of factors. Pica may stop spontaneously in children and pregnant women, but can go on for years in people with mental and developmental disabilities unless treatment is sought. In the case of those with special needs, sometimes medication can be used to lessen the pica eating. Regardless of the root cause, seeking a doctor’s help is key to starting the road to recovery.

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