How to Recognize Pica
Pica is an eating disorder that causes people to compulsively eat items not designated for eating. A person with pica might eat relatively harmless items such as ice cubes or may potentially eat dangerous things like dried paint flakes that can result in poisoning. An underlying cause of pica can be a nutritional deficiency or developmental disability, which makes people crave nonfood things. Pica can develop in any person, but it is most common in children, pregnant women, and individuals with intellectual disabilities. It can also develop as a coping mechanism. Although pica is usually temporary, it can have potentially serious consequences. You can recognize pica by identifying physical symptoms and observing emotional signs.
1. **Watch eating patterns.** A person with pica usually maintains a regular diet of food along with eating non-food items. Pica is present when a person eats non-food items consistently for at least a month. If you suspect that you or another person has pica, keep a mental note or journal of eating habits. This can help identify patterns in consumption that may indicate pica. Some common items a person with pica eats include:

Ice
Chalk
Soap or laundry starch
Clay, dirt, or sand
Hair
Cigarette butts or ashes and/or burnt matches
Paint, glue, plaster or chalk
Feces
Talcum powder, cornstarch, or baking soda
Toothpaste
Mothballs
Stones
Coffee grounds
2. **Look for physical manifestations of pica.** People who have pica eat items that are not appropriate for their age or cultural practices. Eating these non nutritive things can have various symptomatic manifestations from mild to severe. Manifestations may include:

Constipation or intestinal obstruction
Diarrhea
Intestinal hemorrhage
Severe tooth abrasion
Tooth loss
Choking
3. **Consider prior medical conditions.** If you suspect you may have pica, think about prior visits to your doctor or medical conditions you’ve had. A person with pica may be more susceptible to certain conditions than others who don’t consume non-nutritive food items. You may have pica if you eat non-food items and have had one of the following health issues:

Lead poisoning or complications thereof
Infections from parasites from animals, especially dogs and cats
Round worm infections
Intestinal ulcerations or perforations
Iron or zinc deficiency syndromes
GI-tract complications
4. **Check feces for nonfood items.** Many small children eat non-food items. If you suspect your child or another person for whom you care has pica, consider checking diapers or in the toilet. You may be able to discern non-food items such as glass, stones, hair, matches, or coffee grounds. Recognize that it may be difficult to difficult to find objects that dissolve in the stomach such as ice, ashes, or soap.
5. **Detect red flags for pica.** Like other eating disorders, pica can present with not only physical symptoms, but also behavioral or emotional ones. You may notice certain behaviors that can indicate pica, especially when they’re in conjunction with physical symptoms. These include:

Skipping meals
Making excuses for not eating
Withdrawing from normal social activities
Leaving during meals to use the bathroom
Expressing disgust, shame, or guilt about eating habits
Eating in secret
6. **Acknowledge negative feelings.** Individuals with eating disorders often have negative feelings associated with their condition. Acknowledging that you or another person have these types of feelings can help you recognize pica. Negative feelings individuals with pica may have include:

Confusion
Anger
Resentment
Protective of your habit
Fear
Anxiety
Depression
7. **Put the behavior in context.** In some cultures, pica may be a part of everyday life. For example, certain religions and ethnic groups eat clay as a way to treat intestinal issues. However, if eating nonfood items is not a part of your culture or is an inappropriate for the person’s age or developmental stage, it may indicate pica.
Be aware that pica is common in individuals with intellectual disabilities, autism, other developmental disabilities, or differences in the brain. If a person with any of these conditions is showing signs of pica, talk to them about what they’ve been eating. You may get the answer simply by asking. Seek medical attention to help you deal with potential pica in a person with developmental disabilities.
8. **Be aware of risk factors.** Pica can affect persons of any age and gender. However, some people may be more susceptible to it. Recognizing your risk factors may help minimize your risk of developing pica. Risk factors include:

Trichotillomania, or hair pulling disorder
Excoriation, or skin picking disorder
Nutritional deficiencies

Dieting
Parental neglect such as food deprivation or lack of supervision
Mental health conditions such as obsessive-compulsive disorder (OCD) and schizophrenia
Intellectual and developmental disabilities, including autism
Pregnancy
9. **Recognize complications of pica.** Many people with pica may eat seemingly harmless substances such as ice. But in other cases, eating non-food items constantly can result in severe medical conditions and even death. Some of the complications of pica include:

Depression and anxiety
Problems with growth and development
Social and relationship problems
Substance use disorders
Problems at work or school
Lead poisoning
Parasitic infections
Tooth and mouth injuries
Complications from lead poisoning

Intestinal poisoning
Intestinal blockages and/or perforation
10. **Seek medical attention.** If your child consumed a harmful substance, seek medical care immediately. If you or another person are at risk for pica and suspect or recognize that you have the disorder, it’s important to see your doctor as soon as possible. Your healthcare provider can check for anemia or other nutritional deficiencies as well as screen for lead poisoning and parasites. Children 2 years old or younger who live in locations where at least one third of the houses were built before 1950 are especially vulnerable and therefore should be screened for lead. Getting medical treatment for pica can help prevent serious further medical conditions.

Be aware that an eating disorder like pica can be difficult to manage on your own. Medical attention is the best way to get your pica under control.
Tell your doctor about your problem honestly, even if it is embarrassing. This can help your doctor develop an accurate diagnosis and treatment program for you. Remember, a doctor is not there to judge, but help you.
Recognize that your doctor may suggest treatment that includes therapies to remove toxic substances from your body or correct nutritional deficiencies. Your doctor may also suggest meeting with a psychologist, psychiatrist, social worker, or dentist to treat underlying causes.
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