What Is Pica?

Someone with pica disorder eats items that are not considered to be food. 

It is common to see a young child put things in their mouth, like toys, dirt, or sand. But pica, as a health condition, is a little different. It is when someone continues to eat something that is not considered a social norm. 

The ingested items can vary. They can be food-related materials, like eggshells or coffee grounds. They can also be non-food items, like paper or baby powder. People can develop this behavior for a number of different reasons. We’ll explain what is known (and unknown) about pica, how it can lead to some medical problems, and how it is treated.

What causes pica?

There is a lot we still don’t understand about pica and why it happens. For some people, it seems to be a condition that stands on its own without any obvious cause. For others, it is attributed to other coexisting conditions. 

In some cases, pica is thought to be caused by a nutritional deficiency like low iron. It is thought that the lack of iron in the brain causes someone to eat non-food substances. This can further lower the amount of iron in the body, which then worsens the underlying problem. 

Women who are pregnant are also at higher risk of developing pica. But again, experts aren’t quite sure why this happens. Some think it is because women have more nutritional needs during pregnancy. Others think it is because pregnancy raises the risk of developing iron-deficiency anemia. 

Another theory is that the pregnant body may crave non-food items as a method of protection. This is because non-food items may bind harmful substances in the digestive tract. But there is no scientific evidence to back up these claims.

In other cases, pica has been linked to cognitive and mental health conditions. Still, experts aren’t exactly sure what changes in the brain lead to the behavior. Some factors that may lead to pica include:

• Developmental delay

• Autism

• Intellectual disability or other mental health conditions

• Obsessive-compulsive disorder (OCD)

• Schizophrenia 

• Memory loss or injury to parts of the brain responsible for memory

Some people think pica may be linked to stress, too. People with pica have reported that eating non-food items can help lessen feelings of anxiety and stress. Low socioeconomic status, which is a known source of stress, has also been associated with pica. In children, pica is more common if they have experienced abuse or neglect.

What eating behaviors are associated with pica?

People with pica eat non-food items, such as:

• Ice

• Paint chips

• Clay

• Dirt

• Rocks

• Hair

• Crayons

• Chalk

• Flour

• Pencil erasers

• Cigarette butts

• Feces

The pattern of consumption may vary from person to person. But in order to be diagnosed with pica, someone must repeat the behavior for at least 1 month.

What problems are associated with pica?

Pica can lead to a lot of mental and emotional distress. But there also may be some physical problems, including: 

• Mouth or teeth injuries from chewing on or eating non-food objects

• Bowel obstruction, which is a blockage in the intestines caused by a buildup of the non-food substance

• Intestinal infection, particularly with items like dirt, clay, or feces that contain worms or parasites

• Diarrhea or constipation, because non-food items are more difficult for the body to break down and digest

• Lead poisoning, which can result from eating paint chips or large amounts of clay that contain lead

• Iron deficiency, which may not only be a cause of pica, but can also develop (or worsen) in someone with the condition

There are some case reports that suggest eating non-food items (like clay) may affect a growing fetus, and cause harmful neurological effects and motor function delay. But given these are only a small number of case reports, it is hard to know if this association exists. 

How is pica treated? 

Often, pica can resolve on its own. For people who continue to experience symptoms month after month, treatment may help. These include:

• Iron and zinc nutritional supplements: Restoring a normal level of these substances in the body can limit how often a person with pica eats non-food objects.

• Removal of non-food substances: Removing non-food items from the surrounding environment can help prevent pica symptoms. 

• Psychiatric medications: Medications such as selective serotonin reuptake inhibitors (SSRIs) — which is a class of antidepressants — may be used for treating pica symptoms.

• Food replacements: Develop a habit of replacing non-food items with food items. Follow this with positive reinforcement for avoiding the behavior, such as stickers for a child or verbal praise for an adult.

Pica is often underreported because of the feelings of shame or embarrassment associated with it. If it suddenly develops or persists, know that you are not alone. And that it is important to discuss the behavior with your provider. There are many people that can help you, such as a nutritionist, social worker, and mental health professional. This type of multidisciplinary team can address the different needs you might have. 

Why trust our experts?

Written by:

Cherilyn Davis, MD

Cherilyn Davis, MD, is a board-certified pediatrician in New York City. She has held local and national roles at the American Medical Women’s Association including board member of the physician division and physician chair of social media.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

Our editorial standards

Meet our experts