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It is possible that the main title of the report Pica is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.


  • Eating Disorder, Pica Type
  • Pica Eating Disorder

Disorder Subdivisions

  • None

General Discussion

Pica is an eating disorder that is characterized by the repeated eating of non-nutritive substances over a period of one month or longer. Patients may eat non-edible objects such as paint, plaster, dirt, ice, or laundry starch. Pica generally affects small children, pregnant women, and people whose cultural environment is most compatible with the eating of non-food items.


Onset of pica generally occurs when the affected individual is between 12 and 24 months of age. Affected infants typically eat paint, plaster, string, hair or cloth. Older children may eat substances such as animal droppings, sand, bugs, leaves or pebbles. Aversion to food is absent. Complications of the disorder are lead poisoning (from eating lead- based paints) and hairball tumors. Non-food items such as laundry starch, clay, dirt, stones, chalk and limestone are other substances that may be craved by pica patients. Children usually outgrow pica. Rarely, adults may manifest the disorder. Pregnant women sometimes have a craving for unusual foods like pickles or ice, but rarely for non-food items.


While a relationship between pica and iron deficiency has been suggested, a cause and effect relationship has not yet been proven. Some substances which are craved by patients with this disorder interfere with the body's absorption of iron from food. Some authorities believe that pica is a learned pattern of behavior while others theorize that it is due to other cultural, psychological and physiological factors or a combination of these factors. In many cases, correction of iron or other deficiencies in the patient may eliminate the abnormal craving that characterizes this disorder.

Affected Populations

Pica can begin as early as the age of one year. It is usually outgrown by six or seven years of age, but some cases persist until puberty. Some adult women, particularly pregnant women, can suffer from this disorder. Severely retarded people often must be monitored to protect them from eating non-edible substances. Pica is thought to be underreported, and the prevalence is not known with any accuracy. It is considered "developmentally inappropriate" in children older than 18 to 24 months.

Standard Therapies

Treatment of Pica mainly consists of preventing patients from eating the craved, non-nutritive substances. Psychiatric counseling aimed at behavior modification is often recommended. However, for certain cultural reasons, some Pica clay and starch eaters may persist in occasionally eating a lump or two of these items.

When mineral imbalances can be identified in people who have Pica, the imbalance should be corrected with vitamin and/or mineral supplements. In many cases correction of these deficiencies will stop or reduce the craving for inedible substances.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government website.

For information about clinical trials being conducted at the National Institutes of Health (NIH) in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, go to:




Beers MH, Berkow R, eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:858; 2022.

Berkow R, ed. The Merck Manual-Home Edition.2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003:907; 1440.

Fauci AS, Braunwald E, Isselbacher KJ, et al., eds. Harrison's Principles of Internal Medicine. 14th ed. McGraw-Hill Companies. New York, NY; 1998:1164.


Pica: Medical Encyclopedia. MedlinePlus. Update Date: 5/4/2004. 2pp


Gavin ML, Homeier BP. Pica. KidsHealth. Nemours Foundation. Date reviewed: December 2004. 4pp.


Ellis CR, Schnoes CJ. Eating Disorder: Pica. emedicine. Last Updated: September 10, 2002. 10pp.



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For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.