Hektoen International

A Journal of Medical Humanities

Pica: Eating starch and clay

The habit of eating non-nutritious or nonfood substances goes by the name of pica and strikes one as a rather peculiar phenomenon. It applies most commonly to people consuming starch or clay, but at different times and in different areas people have also eaten paper, dirt, soap, cloth, hair, ice, pebbles, charcoal, chalk, hair, or ash. Pica can affect people of any age, but is most commonly seen in pregnant women, small children, and individuals with intellectual disabilities.

It appears that this habit has a long history. In Africa and in the Mississippi delta, people have eaten clay for generations, perhaps because of mineral deficiency of iron or zinc. Starch is part of normal nutrition but becomes harmful if indulged to access. Depending on what is eaten, pica can have serious consequences, ranging from malnutrition and specific deficiencies, to gastrointestinal disease, anemia, renal insufficiency, dental problems, or a heightened risk of infection.

Pica can be dangerous if sharp or indigestible objects are eaten or if toxins, parasites or bacteria are introduced into the body from non-food substances. In tropical parts of Queensland in Australia, children used to chew the sweet flakes of white paint shed from colonial houses and develop lead poisoning with anemia, gout, and renal failure with small contracted kidneys.

Psychiatrists tend to regard pica as an abnormal mental condition, sometimes linked to obsessive compulsive disorder, schizophrenia, autism, or mental deficiency. They recommend replacing nutrients when missing, caregiver supervision, removing access to non-food items (especially for children), addressing any co-occurring physical or mental health issues, behavioral therapy to modify the eating habits, and addressing underlying emotional distress or trauma. They regard pica as often being manifestation of an underlying problem, to be treated with empathy and understanding.



GEORGE DUNEA, MD, Editor-in-Chief


Summer 2023 | Sections | Food

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