Understanding

Pica

Pica is an eating disorder in which a person persistently eats non-food, non-nutritive substances — anything from ice or dirt to chalk, paper, or paint. Unlike anorexia or bulimia, it has nothing to do with weight or body image. It is most common in young children, people with developmental disabilities, and during pregnancy, and it can carry serious medical risks.

Also known as: Includes pagophagia (ice), geophagia (soil or clay), and amylophagia (raw starch)

Most common in young children, people with intellectual or developmental disabilities, and during pregnancy; frequently under-recognized

Written by the Eating Disorder Facts editorial team Awaiting clinical review by Cindy Hawthorn, MD Updated July 20, 2026

What is pica?

Pica is recognized in the DSM-5 as a feeding and eating disorder, defined by the persistent eating of non-food substances that have no nutritional value, continuing for at least one month. To be diagnosed as pica, the behavior must be inappropriate for the person's developmental stage, and it must not be a culturally accepted practice. Because mouthing and eating objects is a normal part of early development, pica is not diagnosed in children under about two years old.

What substances are involved

The range is wide. Commonly eaten substances include ice, soil or clay, chalk, paper, soap, cloth, hair, string, wool, paint or paint chips, raw starch, metal, pebbles, charcoal, and ash. Some forms have their own names — pagophagia (compulsive ice eating), geophagia (soil or clay), and amylophagia (raw starch) — but any non-food substance can be involved.

It is not about weight or body image

This distinguishes pica from most other eating disorders. A person with pica is not trying to lose weight or change their body; the drive to eat non-food items comes from other sources entirely, which is part of why pica is often misunderstood.

The iron-deficiency connection

Pica has a striking association with nutritional deficiencies, especially iron-deficiency anemia (and sometimes zinc). Notably, pica frequently stops after a short course of iron supplementation, which suggests that in many people a deficiency plays a direct role in triggering the behavior — one reason nutritional evaluation is a first step.

Recognize

Signs & Symptoms

Repeatedly eating or mouthing non-food substances such as dirt, ice, chalk, paper, or paint

Strong, specific cravings for a particular substance (for example, ice or clay)

Seeking out and consuming these materials, sometimes secretly

Dental damage or mouth injuries

Digestive symptoms such as stomach pain, constipation, or nausea

Signs of anemia, such as fatigue, weakness, or pale skin

In children, ongoing consumption of non-food items beyond the toddler years

Understand

Causes & Risk Factors

No single cause has been identified. Eating disorders arise from a complex interplay of genetic, biological, behavioral, psychological, and social factors.

Nutritional deficiencies — particularly iron, and sometimes zinc — which are strongly linked to pica

Pregnancy, during which cravings for substances like ice or clay can appear

Intellectual or developmental disabilities, and autism

Young age (though not diagnosed before about age two)

Stress, neglect, or under-stimulation, especially in children

Co-occurring conditions such as obsessive-compulsive disorder or schizophrenia

Note: eating certain substances as part of a cultural or traditional practice is not pica

Health Impact

Health Consequences

Eating disorders have serious medical consequences and can be life-threatening if untreated.

Poisoning — lead poisoning (from paint or soil) is the most common and can cause serious neurological harm
Gastrointestinal blockage or obstruction, which can require surgery
Choking
Dental damage and mouth injuries
Parasitic or bacterial infections from soil or contaminated materials
Constipation and other digestive problems
Electrolyte imbalances
Worsening anemia and nutritional deficiencies

Healing

Treatment Approaches

01 A thorough medical evaluation, including testing for anemia, lead and other toxicity, and any intestinal blockage

02 Correcting nutritional deficiencies — iron supplementation in particular can resolve pica in many cases

03 Behavioral interventions, especially for people with intellectual or developmental disabilities, including redirection and making the environment safe

04 Treating medical complications — for example, chelation therapy for significant lead poisoning

05 Addressing co-occurring conditions such as OCD, autism, or other mental health concerns

06 Caregiver education and support, and reducing access to harmful substances

07 A multidisciplinary team spanning medical, nutritional, psychological, and, where relevant, developmental expertise

There is hope

Recovery is possible with the right help.

Talk to a professional who specializes in eating disorder treatment.

Find Help Near You

FAQ

Frequently Asked Questions

Sources