You are what you eat — and for those with pica, that can be downright dangerous.
The eating disorder drives people to consume things you'd never find on a menu. One doctor described treating a patient whose family had to constantly hide their kitchen sponges — because even when dirty and foul-smelling, the patient would eat them.
"I worked with a patient whose family had to consistently hide their kitchen sponges, because even when they were dirty and foul-smelling, the affected patient would often consume them," said Dr. Erica Brody, a pediatrician at Mount Sinai Kravis Children's Hospital.
Pica, she explained, is the persistent craving and consumption of non-food items that have no nutritional value — ranging from talcum powder and drywall to hair, crayons, and clay.
The disorder's name comes from the Eurasian magpie, called Pica pica in Latin — a bird known for eating just about anything.
Who Gets Pica — and Why
To be diagnosed, a patient must have been eating non-food items for at least a month and be older than two, since babies commonly mouth objects as part of normal development. The items must also fall outside cultural or religious norms — clay, for instance, has been eaten for centuries by farming communities in Peru's Andean highlands as part of traditional practice.
The disorder usually begins in childhood but can appear at any age. Pregnant women are more likely to develop it than the general adult population. While pica is believed to be relatively common, experts aren't entirely sure how widespread it is — research remains limited, and the condition is frequently missed by doctors.
The causes are complex. "In some cases, pica is linked to nutritional deficiencies, particularly iron or zinc," said Dr. Corinne Catarozoli, a psychologist at NewYork-Presbyterian and Weill Cornell Medicine. Other times, it may signal underlying neurodevelopmental conditions such as autism or psychiatric disorders like OCD.
"Behavioral reinforcement also plays a role," Catarozoli noted. "If the behavior reduces anxiety or provides sensory stimulation, it can become habitual." She sees higher rates in populations where biological vulnerabilities — like nutritional deficiencies — intersect with environmental stressors such as poverty or neglect.
The Consequences Can Be Serious
Catarozoli has treated patients who peel and eat drywall, exposing themselves to lead poisoning that can cause lasting damage to a child's developing brain and nervous system. She has also seen patients consume paper products — napkins, towels, tissues — as well as toys and crayons.
Perhaps most alarming are cases involving compulsive consumption of hair and nails, which can clog the digestive system and pose severe health risks.
In one case outside her care, a nine-year-old girl in Vietnam was hospitalized after several days of abdominal pain, vomiting, and weight loss. Examination revealed a massive hairball more than three feet long, coiled from her stomach to her small intestine and completely blocking her gastrointestinal tract. Surgery was required.
"During the examination, we noticed that the child's hair was unusually brittle and standing upright, which prompted us to take a more detailed medical history," said Dr. Le Duc Tuan, from the general surgery department at FV Hospital, where the girl was treated. "Only then did the mother reveal that the child had developed a habit of pulling out and eating her hair since the age of 2 or 3."
The Good News: Pica Is Treatable
Both doctors described pica as "very treatable," especially when identified early.
"In children, it often resolves once underlying deficiencies or developmental factors are addressed," Catarozoli said. The same applies to pregnant women. For individuals with more chronic neurodevelopmental conditions, longer-term management may be needed.
Therapy — particularly techniques based on applied behavior analysis — has been shown to curb dangerous habits and reinforce safer alternatives, especially for children on the autism spectrum.
"Pica is often misunderstood as a strange behavior, when in reality it's a meaningful clinical signal," Catarozoli said. "It can point to underlying medical, nutritional or psychological needs that aren't being met. Early recognition is key — not just to stop the behavior, but to prevent serious complications like intestinal obstruction, poisoning or infection."