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PICA: An Unspoken Eating Disorder

What is Pica?

Pica, a common eating disorder, involves severe disturbances in eating behaviours, thoughts, and emotions. Pica is an eating disorder involving compulsive consumption of non-food items like ice, dirt, paint chips, and clay. It affects 25% to 35% of children and 68% of pregnant women globally. In South Africa, eating rocks or clay soil is called ‘Umcako’ (in IsiZulu), clay-like white sand dug up, moulded into big round balls, and sold per piece. The majority of people (pregnant and non-pregnant) are addicted to it; those who eat it would say it tastes like chalk and sand; it’s the distinct taste that keeps many people addicted. 

 

Cause of Pica

The cause is unknown, but there are a few factors involved. Nutrient deficiency may be associated with Pica, but studies suggest that it is an effect of nutrient deficiency. Pregnant women experience nausea and vomiting relief from certain substances, while 45% enjoy the taste. PICA is believed to be caused by nutrient deficiencies, with iron requirements increasing for foetal growth. Pica cravings usually subside after childbirth. Iron supplementation can help eliminate cravings for iron after five days. However, some studies suggest that PICA may cause nutrient deficiency, as a non-nutritive diet can hinder the absorption of essential vitamins and minerals. Pregnancy is another common cause, with 27% to 60% of pregnant women experiencing PICA. A recent study in Ghana found that 67% of pregnant women ate non-food items due to intense cravings. Although it’s an independent behavioural issue, it tends to be labelled as a symptom of other conditions. 

 

The Cultural Side of Pica

The people who eat Pica rocks are commonly pregnant women, nutrient-deficiency individuals, disabled individuals, and specific cultural groups. Cultural Pica is also a contributing factor where eating non-food items is not only acceptable but common practice and learned behaviour in several communities and cultures; in some parts of rural India, eating things such as mud and clay is believed to carry health benefits and spiritual effects, whereas the “Chagga” Group of African females believe eating soil is associated with reproduction and fertility. 

 

Effects 

Pica is a hazardous condition that can lead to severe complications, such as malnutrition, anaemia, parasites, liver damage, kidney damage, constipation, mercury poisoning, intestinal obstruction, abdominal Issues and death. However, the type and severity of complications depend on the substance ingested; for instance, since paint chips contain toxic substances, consuming them can result in Lead Poisoning, which is often linked to brain damage and death. Other commonly ingested items such as hair, stones and glass can cause intestinal blockages and potentially damage the lining of the digestive tract. These complications become especially worrisome when the patient is a pregnant woman, as a mother’s diet is a vital component of the growth and general well-being of the foetus. Consuming non-food items can have severe consequences for both the mother and child. 

Treatment and Changing the Trajectory

Currently, no specific tests or treatments exist for people with Pica. However, some treatment approaches include preventative educational behaviour control, nutrient treatment, and mental therapy. In some cases, severe patients may undergo pharmacological treatment. Often, Pica goes unnoticed due to embarrassment or personal belief that it’s not worth reporting; however, everyone deserves to receive the attention they need and seeking out treatment is on the path towards that.

Even though this seems like the right way for those craving it to take, it causes harm, and one can try to teach their bodies to be without it, and eventually, they will have a distaste for it. 

Lesego Mogatle

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