Eating disorders are common among individuals. It is assumed by many people that eating disorders are for people seeking to become thin. The images of super models and celebrities come to mind when considering anorexia or bulimia, but eating disorders are experienced by individuals of all backgrounds and lifestyles, and do not necessarily relate to losing weight.

In the United States alone, a country in which a premium is put on the way individuals look, it is estimated that at least 30 million people¹ANAD. “Eating Disorder Statistics | General and Diversity Stats | ANAD.” National Association of Anorexia Nervosa and Associated Disorders, 8 June 2022, anad.org/eating-disorders-statistics. have an eating disorder. The four most well-known eating disorders are anorexia, bulimia, orthorexia and binge-eating.

Eating disorders can tear apart lives, relationships, and families. One person dies nearly every hour of the day due to eating disorders, according to ANAD²Luan, Kathy. “ANAD | Free Eating Disorder Support Groups and Services.” National Association of Anorexia Nervosa and Associated Disorders, 3 Oct. 2022, anad.org.. While anorexia, bulimia, orthorexia and binge-eating are the big four and affect people of all ages, races, and financial standing, they are not the only food-related issues. A person’s physical and mental health are both affected by an eating disorder. Most, if not all, eating disorders originate due to a mental imbalance in which individuals see themselves differently than others do.

One of the more complex and misunderstood eating disorders is Pica. This is a disorder that many people may think is strange and the person is unwell mentally. Pica is not the average eating disorder and doesn’t have the Hollywood glamor of anorexia, bulimia, or binge-eating.

What is Pica?

Pica involves individuals eating items that are not food and contain little or no value in terms of nutrition. Items that are eaten include hair, paint chips, string, and dirt. Individuals suffering from Pica don’t just eat a little bit of these non-food items. Sufferers are compelled to compulsively eat these substances for a period lasting more than one month.³Call, Christine, et al. “From DSM-IV to DSM-5: Changes to Eating Disorder Diagnoses – PubMed.” PubMed, 1 Nov. 2013, pubmed.ncbi.nlm.nih.gov/24064412.

The condition typically begins in childhood. The eating disorder is more common among young children with developmental disabilities. These disabilities can make it difficult to manage and/or treat Pica. There is often an image produced in film or on television of kids in school eating glue, crayons, or other classroom objects⁴Advani, Shweta, et al. “Eating Everything Except Food (PICA): A Rare Case Report and Review – PMC.” PubMed Central (PMC), www.ncbi.nlm.nih.gov/pmc/articles/PMC4015153. Accessed 12 Oct. 2022.. This is an example of Pica, yet while it is done for humorous effect in media, eating items such as this is far from funny.

Children such as infants and toddlers learn about the world around them by putting items into their mouths. It is not uncommon for a child to ingest a non-food item. Pica becomes an eating disorder when the act of eating non-food items becomes a repeated action. Pica may be diagnosed when steps are made to prevent a child from consuming non-food items, yet the child finds a way to circumvent any type of redirection. Research has found that 25% to 30% of all children experience Pica.

Although it often starts in childhood, people can carry it over into adulthood. Adults with Pica tend to eat non-food items that are associated with their childhood or the home they grew up in.

What are the signs of Pica?

There are several warning signs. However, the eating disorder isn’t one that necessary stands out in the beginning and can be overlooked at first. Pica warning signs include:

• Persistent eating of non-food items with no nutritional value for at least one month
• Eating the non-food item is not part of a cultural, religious, or social practice
• Depending on age, substances can vary
• Consumed substances may include paper, soap, hair, string, chalk, paint, metal, ash, and/or talcum powder
• Eating the non-food item(s) is not developmentally appropriate for the individual

Risks of Pica Eating Disorder?

Pica is a mental health disorder and often occurs with other issues including schizophrenia, autism spectrum disorder, and intellectual disability. There are a number of risks that sufferers can experience due to eating non-food stuff. The two biggest risks individuals may experience are iron-deficiency anemia and malnutrition.

These factors can be devastating to children, but adults also experience the disorder. Pregnant women can acquire Pica and developing iron-deficiency anemia and malnutrition can cause harm to both the mother and child. It is believed that pregnant women develop Pica as the body compensates for a lack of minerals and vitamins that are found in foods. However, Pica can also be a more serious mental health condition.

The eating of non-food items can be deadly due to blockages that can form in the digestive tract. Sharp objects can be ingested and cuts or tears can form in the throat and/or intestines. Cuts and/or tears can lead to internal bleeding. Bacteria and poisoning are also risk factors that can result in death.

Individuals at risk of developing Pica include:

• Family history of individuals suffering from Pica
• Low income/poverty
• Trauma
• Neglect
• Co-occurring mental disorders
• Trichotillomania (hair-pulling disorder)
• Excoriation (skin-picking disorder)
• Individuals with other obsessive-compulsive continuum issues

How is Pica treated?

The most effect way to treat individuals suffering from Pica is a behavioral approach. Treatment often includes Cognitive Behavioral Therapy (CBT). The use of CBT builds and improves skills associated with determining edible foods from non-edible items. Family therapy can also be used to manage and treat individuals. Due to the nature of Pica, applied behavior therapy is often prescribed, which is similar to persons with intellectual disabilities.

Although it is claimed around 25% to 30% of all children experience Pica, it is truly unknown how large the disorder is. The reason for a lack of solid figures is due to the disorder being unreported. Adults are afraid to seek help due to feeling the disorder is unnatural.

Pica is a dangerous disorder that can cause physical, mental, and emotion issues in those who experience it. It is important for anyone suffering from Pica or a witness to others who go through it to seek recovery help immediately.

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