Pica is an eating disorder where people eat or swallow non-food items, such as chalk, ice, paint chips, or pebbles. While pica is relatively common in children under the age of six, adults or older children who continue to eat non-food items are experiencing a compulsive behavior that can cause significant harm if left untreated.

Pica treatment can help identify the thought patterns that lead to eating non-food items and help people break free from their eating disorder once and for all. At Koru Spring, our team of eating disorder specialists uses targeted, evidence-based methods to help people overcome their mental health challenges and achieve lasting recovery.

What Is Pica?

Pica — pronounced “PIKE-ah” — is an eating disorder characterized by eating objects that aren’t food and have no nutritional value. Some of the more common items that a person living with pica may consume include:

  • Rocks
  • Ash
  • Paint chips
  • Dirt or clay
  • Talcum powder
  • Chalk
  • Eggshells
  • Feces
  • Paper
  • Soap
  • Cloth
  • Ice
  • Hair

While the exact prevalence of pica in adults is unclear, one study suggests that roughly 5% of adults experience pica while 1% experience recurring pica.

The people who are most likely to experience pica are pregnant women and young children. Certain mental health conditions, such as autism spectrum disorder and schizophrenia, can increase a person’s risk of experiencing pica as well.

Pregnant women show some of the highest rates among any population of people who experience pica, with estimates suggesting that 27.8% of women worldwide will experience pica during their pregnancies.

History of Pica

The word pica was first introduced in the 16th century to describe the craving to eat non-food items. Pica was named after the Latin name for the magpie, a bird that has a reputation for eating anything. But the history of this eating disorder stretches back thousands of years; the ancient Greek physician Hippocrates wrote about pregnant women eating charcoal or earth in approximately 400 B.C.E.

Many more ancient philosophers and physicians continued to write about this disorder, including Aristotle and Pliny the Elder. While the treatments for pica from ancient times haven’t carried over to the modern world, it shows that pica is not a new phenomenon and has affected certain people for millennia.

Causes of Pica

Pica can have a number of different causes, and there is no single factor that leads to this compulsive behavior. However, researchers have determined that certain risk factors may increase the likelihood that a person experiences pica, including:

Iron Deficiency

Iron deficiency often leads to craving or eating inedible substances. When you don’t have enough iron in your diet, you can develop a condition known as anemia, in which your body doesn’t create a typical number of healthy blood cells. This can lead to an oxygen shortage throughout your body and cause you to feel tired or weak.

This reduction in healthy blood cells can lead to an inflammation of the tongue, which may cause pain, itchiness, or irritation. Researchers suggest that this pain may be part of the reason why people turn to eating inedible substances. Chewing on ice, rubber, or other items with no nutritional value can temporarily relieve the discomfort.

Iron deficiency is one of the leading causes of pica, and those who are iron deficient can often find immediate relief when they incorporate a healthy level of iron back into their diet. 


The National Eating Disorders Association lists malnutrition as one of the most common causes of pica. When your body doesn’t get the essential nutrients that it needs, it can cause a number of different symptoms, including fatigue, weight loss, and dizziness. But it can also lead to mental health challenges like pica.

But the connection with malnutrition goes both ways, as many people who live with pica go on to develop malnutrition as a result of the disorder. Eating inedible items can lead to a feeling of satiation but does not provide your body with the essential nutrients required for your physical and mental health.

Mental Health Disorders

Pica is often seen in people who have impaired daily functioning as a result of a mental health disorder. It is often seen in people who live with disorders such as:

  • Autism spectrum disorder
  • Intellectual disability
  • Schizophrenia

In these cases, pica is not necessarily caused by a physical problem but by mental health challenges that can be treated with targeted psychotherapy approaches.

Cultural Factors

Certain cultures and traditions view pica as an acceptable and common behavior under certain conditions. A Catholic church in New Mexico, for example, advocates for the healing power of the soil in which a crucifix was discovered centuries ago.

A tribe in Nigeria makes regular trips to a specific lake to consume a certain type of soil, which they also feed to their cattle.


Finally, stress has long been associated with pica behaviors in both children and adults. People are more likely to experience pica if they were neglected, abused, or experienced significant trauma, and it may be used as a coping mechanism to deal with these mental health challenges.

Symptoms and Warning Signs That Someone Has Pica

The most obvious sign that someone is experiencing pica is if they are eating substances that have no nutritional value. But there are other warning signs that someone may be experiencing pica as well, even if you haven’t witnessed the classic behavior itself.

Common symptoms and signs of pica include:

  • Constipation
  • Stomach discomfort, which may be a sign of intestinal obstruction or blockage
  • Irregular heart rate
  • Lead poisoning

Sometimes, eating substances that aren’t food can result in serious infections or poisoning. These challenges can have their own complex set of symptoms but can also indicate that a person is consuming non-food items.

Health Risks of Pica

The biggest health risks of pica come in the form of accidental poisoning, nutrient deficiencies, and gastrointestinal issues. The relative risks depend largely on the type of items being eaten and the amount of non-food items being eaten. Certain items may be:

  • Poisonous or toxic
  • Create blockages in the small or large intestine
  • Have sharp edges that can damage the intestinal tract
  • Lead to viral or bacterial infections

However, another risk for many people is the stress that pica can cause. Pica is a compulsive mental health condition, and people may feel ashamed, anxious, or distressed about their habit of eating non-food items.

How Pica Is Diagnosed

Mental health professionals use a number of evidence-based tools to assess and diagnose pica. One such tool is the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, which outlines four main criteria used to diagnose pica:

  1. A persistent pattern of eating non-food items, lasting at least one month
  2. Eating non-food items is inappropriate for an individual in a developmental context
  3. The pattern of eating non-food items isn’t a cultural or socially acceptable practice
  4. If the pattern of eating non-food items occurs alongside a mental health disorder, it is severe enough to require further clinical attention

A diagnosis of pica is typically considered severe enough to suggest clinical intervention is necessary. Pica treatment can help you overcome the compulsion to eat non-food items and can help break the thought patterns and behaviors that are interfering with your life.

How Pica Is Treated

The path to treating pica depends on several different factors. As mentioned above, some people experiencing pica can find total relief with adequate nutrition and mineral intake, while others will need to take a psychotherapeutic approach to achieve recovery. 

People with co-occurring mental health challenges may need a more comprehensive mental treatment program, which can address both pica and the additional mental illness simultaneously.

Some of the most common therapeutic approaches for treating pica include:

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is an evidence-based approach for helping people overcome their disordered behaviors by helping people identify, challenge, and change the thought patterns that precede them. CBT is based on the principle that thoughts, emotions, and behaviors are all interconnected — and that by changing the way you think, you can change the way you behave and feel in response.

CBT is typically done with a licensed mental health counselor or psychologist and is offered in both individual therapy and group therapy formats. It is one of the most rigorous and well-studied therapeutic styles and can provide lasting tools and techniques to help you overcome all types of mental health challenges in the future.

Aversion Therapy

Another approach that can be beneficial to helping people break the pattern of eating non-food items is mild aversive therapy. This style of therapy uses small but impactful consequences that can help people change the way they feel about eating non-food items.

For most people experiencing pica, the act of eating non-food items feels rewarding. Mild aversive therapy seeks to change this feeling by pairing the act of eating non-food items with unpleasant stimuli. It also seeks to make eating healthy and nutritious food feel more rewarding.

By equating non-food items with consequences and healthy foods with rewards, people will begin to avoid the pattern of eating associated with pica and focus on eating a healthy and balanced diet.

Residential Treatment

For people who are experiencing severe side effects or putting their health in danger because of their compulsive consumption of non-food items, residential treatment is often recommended. 

Residential treatment at an eating disorder treatment facility can connect you or your loved one to a team of mental health professionals who offer a variety of evidence-based treatment methods. Engaging in residential treatment also removes the triggers and stressors of the outside world that often lead to compulsive behavior.

A residential facility offers 24/7 support for people with pica, can provide you with social support networks to help aid you in your recovery, and can show you that the path to pica recovery is possible. 

In addition, residential treatment centers like Koru Spring offer a wide range of mental health and medical services, helping people who have co-occurring mental health disorders achieve a more holistic recovery.

Residential treatment is just one of the levels of care offered at Koru Spring. Partial hospitalization programs and intensive outpatient programs can offer the same therapies and treatments but in a less intensive and structured format.

Start Pica Treatment at Koru Spring

Koru Spring is a dedicated eating disorder treatment facility in Jacksonville, Florida, for women who need help overcoming their mental health challenges. Our multidisciplinary team includes clinical dietitians, mental health therapists, and supportive care staff who can help guide you on the path to recovery.

Starting pica treatment can be nerve-racking, but you can make progress and start living a better life when you seek out evidence-based treatments that work.

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