What is pica, the disorder that’s making a 3-year-old eat her sofa and walls?

It’s not unusual for infants to put non-edible items in their mouth as a way to explore the world around them. However, some of them may continue with this habit despite knowing they aren’t supposed to eat these items. Common in both children and adults, Pica is an eating disorder that can lead to strong and persistent urge to eat non-edible items from chalk, dried paint, paper, soap, to clay, in people. The causes of the disorder can range from nutritional deficiencies to mental health conditions like autism or OCD. For many, these tendencies are their way of coping with their emotions. (Also read | Sleep related eating disorder: Symptoms and signs to contact a doctor)
The viral story of a 3-year-old girl eating chunks of sofa, wool from her toys, candle wax, and even dangerous items like shards of glass from photo frames has put spotlight on this rare eating disorder which can often affect children, pregnant women, and those with mental health disorders.
Pica is an eating disorder where a person has a strong and persistent urge to eat non-food substances.
“A person with pica might eat relatively harmless items, such as ice, or they might eat potentially dangerous items, like flakes of dried paint, chalk, or paper. Pica can occur in children, pregnant women, and individuals with certain developmental or mental health conditions,” says Dietitian Varsha Krishna Gade, Consultant- Dietitian & Nutritionist, Motherhood Hospitals, Kharadi, Pune.
“One of the potential causes of pica eating disorder is a nutrient deficiency, particularly iron or zinc. Pica is more common in pregnant women, and it is thought to be related to changes in hormone levels and nutrient demands during pregnancy,” adds the expert.
People affected by this condition may eat these things compulsively and can eat items like chalk, paint, soap etc. Ingesting these things can lead to serious health woes.
“People with Pica ingest items like chalk, dirt, paint, etc – which are often of no nutritional value. Some may even consume cigarette ashes, hair, soap, clay or talcum powder which in the long run may lead to serious health conditions. Hoarding and showcasing uncontrollable tendencies towards not fit-to-eat items are a few behavioural symptoms of Pica,” says Dr. Mazher Ali, Consultant -Psychiatry, CARE Hospitals, Banjara Hills, Hyderabad.
Dietitian Varsha says people with Pica may not be able to control their urge to eat something non-edible and can’t stop even when they want to. This can lead to many complications.
There are many factors that could lead to development of Pica from stress and anxiety to sensory processing issues.
“Psychological factors can also contribute to the development of pica eating disorder. Some individuals may use consuming non-food items as a coping mechanism for stress, anxiety, or trauma. Sometimes, individuals with certain sensory processing issues or sensory seeking behaviours may be drawn to eating non-food items for their texture, scent, or mouth feel, for example chalk,” says Dietitian Varsha.
“Pica eating disorder is not tied to a single root cause. However, sometimes it can be associated with nutritional deficiencies such as zinc or iron, also observed in pregnant women. Another cause is linked to mental health conditions namely schizophrenia, autism disorder, OCD, etc where Pica might emerge as a coping- mechanism,” says Dr Mazher.
“A thorough medical evaluation to determine the underlying cause is recommended for Pica. Treatment for Pica can range from behavioural therapy to treating nutrient imbalances with the use of supplements. For some individuals, psychological evaluation and medication may be prescribed, or both. Modifications to the environment may also be recommended to help reduce compulsive behaviour,” adds Dr Mazher.
According to Dietitian Varsha, risks to Pica can be managed through a multi-disciplinary approach that caters to individual needs.
• Seeking medical evaluation and addressing complications that are contributing factors to pica.
• Behavioural therapy and interventions to assist individuals.
• Working with a nutritionist or dietitian to treat nutritional deficiencies.
• Monitoring both mental and physical well-being along with identifying triggers of relapse.
• Support from loved ones- especially family members may reduce the risk.