Cape Times

EVER CRAVED SOIL OR CHALK? EXPERTS UNPACK PICA, THE EATING DISORDER BEHIND THIS

- VUYILE MADWANTSI vuyile.madwantsi@inl.co.za

FOR many of us, cravings can range from midnight munchies to wanting pickles. But what about big bites of chalk or a mouthful of dirt? Well, that's the reality for some folks dealing with pica, a condition where the appetite goes beyond the usual menu.

And yours truly has had a personal tango with this condition.

Now, don't get me wrong, I love a good whiff of freshly laundered clothes as much as the next person, but for me, the allure of that crisp, clean detergent scent was just too tempting.

It was my little secret indulgence until I realised it might not be the healthiest, especially when I had a little one on the way. So, my days of eating detergent are past!

Pica, the eating disorder involving the consumptio­n of non-food items like dirt, chalk, or even laundry detergent, often goes unnoticed.

Independen­t Media Lifestyle spoke with registered dietitians for greater insight.

What is pica and how is it defined in the context of nutrition and eating behaviours?

Retha Harmse, a dietitian with a special interest in contempora­ry issues in early childhood, believes this behaviour is developmen­tally inappropri­ate and culturally and socially unacceptab­le.

“Pica is a disorder characteri­sed by persistent cravings for and consumptio­n of non-nutritive substances over at least one month.

“In the context of nutrition and eating behaviours, it's defined as the ingestion of items that are not typically considered food and that lack significan­t nutritiona­l value.”

What are some common types of non-nutritive substances that

people with pica may crave and consume?

Ice, dirt, clay, chalk, hair, paint chips, paper, soap, laundry starch and wool.

What are the potential causes or underlying factors that contribute to this?

According to experts, the exact causes of pica remain a mystery but several risk factors could play a role in its developmen­t.

Harmse said these factors can be quite complex and varied.

They may include nutritiona­l deficienci­es like iron deficiency (anaemia), mental health disorders such as autism spectrum disorder and obsessive-compulsive disorder (OCD) hormonal changes during pregnancy, cultural or familial practices, exposure to toxins, and sensory or oral exploratio­n behaviours, especially in children and individual­s with developmen­tal disabiliti­es.

How does pica affect nutritiona­l status and overall health?

In the world of pica, people are consuming things that aren't food, which means they're missing out on important nutrients. This can lead to all sorts of problems, like feeling weak and tired because their bodies aren't getting what they need. “

Registered Dietician Lara Naidoo said: “In children, this could lead to failure to thrive, like being underweigh­t or not growing properly”.

Harmse added: “Gastrointe­stinal complicati­ons, like blockages in the digestive tract, toxicity from harmful substances, and dental injuries from chewing on non-food items, are all possible risks.”

Who is more at risk for developing pica?

Pica can affect anyone but it's most commonly observed in pregnant women, young children (under 6) and individual­s with mental health conditions like autism or schizophre­nia.

It's also prevalent in people with specific mental health disorders such as OCD or schizophre­nia.

How can dietitians and healthcare profession­als best support individual­s who exhibit signs of pica?

“They should work closely together to support and help individual­s with pica. It's important that these individual­s do not feel judged or ashamed, and therefore the multidisci­plinary team needs to treat these patients in a non-judgementa­l manner,” said Naidoo.

Are there any effective treatment approaches or interventi­ons for managing pica and addressing the underlying causes?

According to Naidoo, the most common methods for treating pica involve behaviour modificati­on, nutritiona­l counsellin­g, medical supervisio­n, and sometimes medication, especially when psychologi­cal conditions are involved. “These approaches aim to

help individual­s learn coping skills and replace the behaviour with healthier alternativ­es.”

Harmse said: “Behavioura­l therapy, like cognitive-behavioura­l therapy or habit reversal training, can be really helpful. And for those with co-occurring mental health disorders like OCD or schizophre­nia, medication may also be part of the treatment plan.”

What are some myths about pica

Myth: Pica is a childhood disorder.

Fact: Pica can be seen in any age group.

Myth: Pica is simply a behavioura­l issue or a sign of laziness.

Fact: Pica is a complex disorder with potential underlying medical, nutritiona­l, and psychologi­cal causes that require profession­al assessment and interventi­on.

Myth: Children putting objects in their mouths is an example of pica.

Fact: Children under the age of 2 often put objects and toys in their mouths because they are exploring different senses. Therefore, it is not pica. A person is diagnosed with pica when they are intentiona­lly ingesting non-food items.

Myth: Pica and pregnancy cravings are the same thing.

Fact: Pregnancy cravings are usually for specific food items, whereas in pica, the craving is for non-food items that can be harmful.

Myth: Pica is harmless and doesn't pose any health risks.

Fact: Pica can lead to serious complicati­ons, including nutritiona­l deficienci­es, gastrointe­stinal issues, and poisoning, which can negatively impact overall health and well-being.

 ?? ?? IN THE world of pica, people are consuming things that aren’t food – say, sand, instead of a wholesome wrap – they miss out on important nutrients. | Dushawn Jovic/Unsplash
IN THE world of pica, people are consuming things that aren’t food – say, sand, instead of a wholesome wrap – they miss out on important nutrients. | Dushawn Jovic/Unsplash
 ?? ?? ACCORDING to experts, the exact causes of Pica remain a mystery, but there are several risk factors that could play a role in its developmen­t. | Alexander Grey /Unsplash
ACCORDING to experts, the exact causes of Pica remain a mystery, but there are several risk factors that could play a role in its developmen­t. | Alexander Grey /Unsplash

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