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Pica ˈpī-kə

By Evelyn Attia, MD, Professor of Psychiatry; Professor of Clinical Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute; Weill Cornell Medical College, New York Presbyterian Hospital
B. Timothy Walsh, MD, Ruane Professor of Psychiatry; Founding Director, Eating Disorders Research Unit, College of Physicians and Surgeons, Columbia University; New York State Psychiatric Institute

Pica is characterized by eating things that are not food.

People with pica regularly eat things that are not food (such as paper, clay, dirt, or hair). For children under 2 years old, this behavior is considered developmentally normal. Such children frequently put all sorts of things in their mouth and sometimes eat them. Pica may occur during pregnancy.

In some areas, eating things that are not food is part of a cultural tradition, such as folk medicine, religious rites, or common practice. For example, some people in the Georgia Piedmont regularly eat clay.

Usually, what people with pica eat does not harm them. However, sometimes what they eat causes complications, such as constipation, blockages in the digestive tract, lead poisoning from eating paint chips, or a parasitic infection from eating dirt.

Pica itself rarely interferes with social functioning, but it often occurs in people with other mental disorders that do interfere with social functioning. These disorders include autism, intellectual disability, and schizophrenia.


  • A doctor's evaluation

  • Tests to check for possible complications

Doctors usually diagnose the disorder by determining what the person has been eating.

Pica is diagnosed when people persistently eat things that are not food for 1 month or longer. The disorder is not diagnosed in children under 2 years old because at that age, eating such materials is considered part of normal development. It is also not diagnosed when eating such materials is part of the person's culture.

If doctors suspect the disorder, they evaluate nutritional status to check for weight loss and nutritional deficiencies (see Overview of Nutrition : Evaluation of Nutritional Status).

Sometimes pica is diagnosed when a child has symptoms of a blockage in the digestive tract (such as severe cramping or constipation—see Intestinal Obstruction : Symptoms) or lead poisoning (see Lead Poisoning : Symptoms) and is taken to the emergency room or to see a doctor.

X-rays may be taken to check for blockages in the digestive tract. Blood tests may be done to check for lead poisoning or a parasitic infection.


  • Sometimes behavioral modification

  • Treatment of nutritional deficiencies and complications

Behavioral modification techniques may help, but little is known about specific treatments for this disorder.

Nutritional deficiencies and complications are treated. Blockages in the digestive tract may require surgery.

The disorder may last several months, then disappear on its own, particularly in children.