Pica: a Dangerous, Surprising Eating Disorder

Bonnie Taub-Dix

Over the past several decades I've counseled patients who eat too much, eat too little, obsess over every bite or fear food. Unlike the more publicized and documented eating disorders, a dangerous disorder that is not often talked about is pica. Pica is defined as the consumption of non-food substances for at least one month in duration. Most commonly, this means eating dirt, paint, paper, ice, clay and even feces.

According to a 2011 study, hospitalizations for this sparsely known disorder rose 93 percent between 1999 and 2009, and this dramatic increase may be an underestimation because of its likelihood to go unreported.

For those of us without the urge to eat inedible items, it may be unfathomable to understand what could possibly drive someone to consume such things. One cause may be due to mineral deficiencies, such as iron deficiency, anemia or zinc deficiency, which could lead to such unusual cravings. Psychiatrists and physicians also state that some partake in this activity because they enjoy the taste, texture or smell of the items they eat. Additionally, continuous intake activates the reward circuit in the brain, making the patient crave more.

Here's what you need to know about this silent eating disorder:

-- Who is affected? Pica is most commonly diagnosed in women and children, especially those with mental and developmental delays -- particularly schizophrenia and autism.

[Read: 5 Eating Disorder Signs in Your Child .]

-- Ten to 32 percent of children ages 1 to 6 partake in this obsessive-compulsive behavior. While we may have a picture of a child eating paint or glue out of curiosity, this can become more than a one-time occurrence. It can become particularly dangerous if a child eats paint chips from lead-based paint, increasing the risk of lead poisoning. If you live in an old house, your child could be particularly vulnerable, so beware of warning signs -- such as developmental delays, learning difficulties, weight loss with loss of appetite, fatigue, irritability, abdominal pain, vomiting and constipation.

-- Pregnancy can precipitate pica. The first trimester of pregnancy can spontaneously provoke abnormal cravings for anything from laundry detergent to coffee grinds. Currently, physicians and researchers do not know what provokes the strong draw for such items.

[Read: Orthorexia: An Unhealthy Obsession With Healthy Eating.]

-- Cultural norms may define this disorder. In some cultures, it's customary to eat clay or dirt, sometimes out of socioeconomic necessity. The result can be gastrointestinal upset and its related complications.

-- Some cases involve food not eaten alone or in such large quantities. For example, some pica sufferers will eat boxes of cornstarch weekly. While this is safe for consumption in small doses -- like to thicken a pie filling -- consuming it in excessive quantities could spike blood glucose concentrations and even predispose patients for diabetes.

[Read: How to Talk to a Friend About an Eating Disorder .]

-- Treatment varies. Since no two cases of pica are exactly the same, the course of treatment is largely dependent on the underlying cause, substance ingested, symptoms and psychiatric pathology, if any.

-- It's not trendy. Despite recent celebrity endorsements of clay-eating to detoxify the body, consuming non-food items can do more harm than good. We have two kidneys, a liver and five feet of colon to rid any toxins we may ingest. Eating healthy fruits and vegetables, which contain antioxidants, also helps keep our bodies free from toxins. I don't actually know of any celebs who hold degrees in nutrition, yet sadly, stargazers often follow their leads on fad -- and often dangerous -- dieting habits. It's less risky to mimic a star's style of clothing than to replicate what's on her plate.

[See: The Eating Disorder Spectrum -- From Pregorexia to Drunkorexia.]

This silent eating disorder is serious and can lead to severe complications, such as gastrointestinal upset, obstruction and even organ perforation. Additionally, this disorder can destroy teeth and cause mental upset. In the past, rising awareness of other eating disorders -- such as anorexia nervosa and bulimia nervosa -- helped those rates decline. Health professionals are hopeful the same will occur with pica. If you, or someone you know, suffers from the symptoms mentioned above, please seek the help of a health care provider.

Bonnie Taub-Dix, MA, RD, CDN, has been owner of BTD Nutrition Consultants, LLC, for more than three decades and she is the author of Read It Before You Eat It. As a renowned motivational speaker, author, media personality, and award-winning dietitian, Taub-Dix has found a way to communicate how to make sense of science. Her website is BetterThanDieting.com.