Easter is getting closer and, for many, thoughts of delicious family dinners from childhood or foods long-forgotten have put taste buds into overdrive.

For some, the memory of home works up a craving for grandmother’s old-fashioned sweet potato pie. For others, it’s the way that grits smell in the morning after being cooked and topped with a heaping spoon of syrup that makes mouths water. There are a variety of ways that individuals choose to consume their food, whether it be hot sauce on rice or peanut butter on egg sandwiches. However, there are times when odd food cravings become extreme and can ultimately harm the body.  The habit of chewing ice cubes, a common practice, may seem harmless, however, a strong appetite for non-food items like ice may result in an eating disorder.

Pica is a medical eating and mental disorder that involves strong cravings for non-nutritive items such as chalk, soil, clay, mucus, urine, hair, wood, coal, plastic, paper, pencil erasers, burnt coal, and even animal feces. The list goes on and includes an abnormal appetite for food ingredients such as raw rice and flour. To be diagnosed with pica, an individual must be continuously consuming non-food objects for more than a month. The disorder has been identified in children and adults, most particularly in individuals with disabilities. Ice is a popular item of choice for individuals who have pica.

Research suggests that 25 to 33 percent of young children and 20 percent of adults have been diagnosed with pica. Young children are naturally curious about their environment as they attempt to navigate and learn the world. This is why it’s not strange to find young kids nibbling on crayons or tasting sand in a sand box.  However, the persistent ingestion of non-food items past two-years-old is considered inappropriate and the root of the harmful eating disorder pica.

Pregnancy brings on an onslaught of atypical cravings. Some women experience a need for strange flavor combinations, such as jalapeño peppers on their ice cream or bananas with mustard.  Pica has also been identified as a common eating disorder for pregnant women. The consumption of non-food items, such as clay, during pregnancy has been tied to African traditional beliefs about maintaining a healthy pregnancy by warding off unwanted spirits or illnesses that may complicate birth. The practice of geophagy has been around for centuries, and anthropologists believe it is a concept that was brought the United States by African slaves.

According to Pamela Goyan Kittler and Dr. Kathryn Sucher’s recently published book, Food and Culture, the eating disorder is more prevalent amongst African-American women than Caucasians, most particularly in the Southern United States where close to 16 to 57 percent of women admit to having pica. In rural regions, clay is popularly consumed by pica patients, whereas in urban environments with larger populations of African-Americans, starch, coffee grounds, and ice are the items of choice.

But how do women develop pica?

The reason for why women subscribe themselves to this practice of unhealthy ingestion varies widely. Some women consume non-food items because they feel that they have a nutritional deficiency. A lack of certain vitamins and minerals can trigger strange dietary cravings. In some cultures or regions, it is believed that the consumption of clay during pregnancy prevents babies from being born with oddly placed birthmarks and gives them lighter skin and makes the birthing process less painful.  Pica has also been credited as a hallmark of other mental illnesses and used to relieve stress and fear.

Although pica has become a common cultural practice worldwide and nationally, the prevalence of the disorder in the United States goes underreported, simply due to the embarrassing nature of stigma and negative stereotypes. Often, individuals who have become attached to eating dirt, ice, or chalk, suffer from the co-morbidity of other mental disorders, such as obsessive compulsive disorder (OCD), and may choose not to reveal these secret cravings because of their misconception that they will simply grow out of it.

There are four developmental stages of pica. However, pica in its most basic form can lead to an iron-deficiency, anemia, or lead poisoning.  Individuals who consume non-food items like rocks, dirt, or hair, also run the risk of bowel obstruction, which can lead to constipation or inflammation. It is also very harmful to have pica during pregnancy, as the consumption of these items prevents the body from absorbing the minerals and nutrients that a baby needs to develop. This can result in a premature birth, low body weight, and stillbirth.

It is important to understand that eating disorders exist in a variety of forms—it’s not simply about extreme dieting measures to lose weight or the practice of vomiting to purge the body of food for the same purpose. In itself, pica is, like other eating disorders, a mental issue because of the ways in which women’s consumption of items that are hazardous for the body becomes a natural routine. In our community, stigma and embarrassment is a leading factor for why ill patients refuse or deny medical help. A strong awareness of the self, education about health issues, and comprehension of the value of mental health, are necessary for communities of color to overcome health barriers.

If you believe that you or a friend may be suffering from pica-like behaviors, it is important that you seek the medical attention of a healthcare professional. The most common treatments used for pica include nutritional supplements, prescribed medications for the mental disorder aspects of the disorder, psychological counseling, and behavior therapy.

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