What is pica?

Pica is a type of eating disorder where a person craves or eats items that have no nutritional value and are not considered to be food. Your doctor will diagnose pica when this behaviour happens several times for at least one month. It is most common during pregnancy and in children. Other people may also experience pica for a range of reasons.

Pica can be hard to spot. This is because eating non-food items has a stigma, and people may try to eat in private.

Objects consumed by people with pica can include a wide range of items. Some of the most common forms of pica have specific names. Objects that people eat can include:

• soil and clay (geophagia)
• ice cubes (pagophagia)
• raw starch, such as cornstarch and laundry starch (amylophagia) or uncooked rice (rhizophagy)
• paper or cardboard
• paint or metal

Pica can happen with underlying health conditions, such as iron-deficiency anaemia and some psychological conditions.

Pica is not the same as accidentally eating unsafe foods. Read more on accidentally eating unsafe foods.

What are the symptoms of pica?

The key symptom of pica is craving and eating things that are not food. Usually, people with pica will only crave one non-food item. Sometimes people crave a few different types of objects.

Eating non-food items can cause other health problems. These may include:

• stomach issues
• bowel obstruction
• damage to your teeth
• choking due to swallowing objects

Some items such as soil, have a risk of being toxic and can lead to poisoning or infection.

What causes pica?

Doctors don't fully understand what causes pica. Research shows that certain people are more likely to have the condition. Pica is more often experienced by people who have mineral deficiencies, such as:

• iron
• magnesium
• zinc

Pica is more common in pregnancy. This might be because it is linked to iron-deficiency anaemia, which is common in pregnancy.

Pica is also associated with:

• autism
• delayed intellectual development
• schizophrenia
• obsessive-compulsive disorder (OCD)

Some people eat a non-food item because they just enjoy the texture or taste.

When should I see my doctor?

You should see your doctor if you or your child crave unusual non-food items. It could be a sign of iron deficiency.

You may find it embarrassing to tell your doctor about your unusual eating habits. Your doctor will not judge you and can help you find a way to manage your pica cravings.

You should also see your doctor if you have other symptoms of iron-deficiency anaemia, such as:

• tiredness and difficulty concentrating
• shortness of breath
• hair loss

Some pica cravings can lead to poisoning or toxicity. You may have swallowed a poison if you or your child have:

• stomach pain or vomiting
• difficulty breathing
• seizures
• a skin rash or burning sensation on your lips, tongue or throat

How is pica diagnosed?

To diagnose pica, your doctor will ask you about your eating habits. Pica can be hard to diagnose if you do not tell your doctor about your non-food cravings.

If your doctor thinks that you may have pica, they will refer you for a blood test to check your iron levels and for any signs of lead poisoning.

How is pica treated?

Treatment for pica depends on the cause of your cravings. There is no single way to treat pica that works for everyone.

Your doctor may treat the underlying condition or refer you to other health professionals, such as dietitians or psychologists, to help:

• If lack of iron or other nutrients is causing pica, your doctor can recommend supplements or other treatments to increase your levels.
• If a psychological condition is causing pica, you may benefit from medicines or behavioural therapy to control the condition.
• Meeting with a dietitian or a therapist can also help you deal with your cravings. They can help you change your environment so you can avoid coming across your pica items.

You and your healthcare team will work together to decide the best treatment plan for you.

What are the complications of pica?

The complications of pica come from the dangers and problems associated with eating non-food items. Because complications of pica can cause harm, if you think you or your child may have pica, it's important to see your doctor as early as possible.

Problems that may occur include:

• poisoning
• blockages in the throat, stomach or bowels
• infection from contaminated items
• dental problems

Pica can also cause social problems and stress for the person affected.

If you have pica, early diagnosis means you can start treatment and help prevent any complications.

Can pica be prevented?

Pica caused by nutritional deficiencies can be prevented by managing the deficiency. Ask your doctor if nutritional supplements can help.

While pica cannot always be prevented, early discussion with your doctor can help you manage the cravings and behaviours before they lead to any physical harm. Taking action early may reduce your chance of long-term physical, psychological or social harm.

Resources and support

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

• The InsideOut Institute for Eating Disorders has more information on pica and resources on how to get assessed.
• You can speak confidentially to the Butterfly National Helpline. Call 1800 33 4673, 8am to midnight AEST, 7 days a week.
• Eating Disorders Families Australia (EDFA) supports the families and carers of people with an eating disorder. You can call them on 1300 195 626.
• For advice and to connect to local mental health services, call Medicare Mental Health on 1800 595 212.
• headspace has free online and telephone support and counselling to young people aged 12 to 25 years and their families and friends. Call 1800 650 890, or chat online.

Aboriginal and/or Torres Strait Islander peoples

• Yarn Safe by headspace is for people aged 12 to 25 years with online and phone support on 1800 650 890.
• WellMob Healing Our Way offers online resources on social, emotional, and cultural wellbeing.
• Find an Aboriginal Community Controlled Health Organisation (ACCHO) or Affiliate near you.

Other languages

• Embrace Multicultural Mental Health offers mental health resources and personal stories translated in more than 30 languages.

Information for sexually and gender-diverse families

QLife provides nationwide telephone and web-based services for peer support and referral for people wanting to talk about a range of issues including sexuality, identity, gender, bodies, feelings or relationships. Call 1800 184 527.