Pica: Common but Commonly Missed

, , and , Department of Family Medicine, Wayne State University, Detroit.

J Am Board Fam Med. 2000;13(5) 

In This Article

Abstract and Introduction


Background: Pica is the compulsive eating of nonnutritive substances and can have serious medical implications. Although it has been described since antiquity, there has been no single agreed-upon explanation of the cause of such behavior.
Methods: Databases from MEDLINE and PSYCH-Lit were searched from 1964 to the present to find relevant sources of information using the key words "pica," "obsessive-compulsive disorder," "iron-deficiency anemia," and "nutrition."
Results and Conclusions: Pica is observed most commonly in areas of low socioeconomic status and is more common in women (especially pregnant women) and in children. To our knowledge, the prevalence of pica is not known. Numerous complications of the disorder have been described, including iron-deficiency anemia, lead poisoning, and helminthic infestations. Pica is probably a behavior pattern driven by multiple factors. Some recent evidence supports including pica with the obsessive-compulsive spectrum of disorders. Many different treatment regimens have been described, with variable responses. It is important to be aware of this common, but commonly missed, condition.


One of the many unsolved mysteries in medicine is the teleologic or physiologic basis of pica, the compulsive eating of nonfood substances. Many common problems encountered in daily practice can be caused by pica. Our purpose is to draw the attention of primary care physicians to the manifestations, potential screening methods, and potential treatment approaches for this eating disorder.


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