Most people know about bulimia and anorexia. But few know about pica.
When I was younger, I would lie in bed and read stacks of Archie comics. Then I would slowly rip off pieces of the back covers and eat them until there was nothing left. I knew the dyes in the paper couldn’t be good for me; still, I couldn’t stop.
I ate many kinds of paper back then, but comic covers were undoubtedly my favorite. I relished the paper’s grainy taste, and the way it dissolved into a wet, chewy mass in my mouth.
And it wasn’t just paper that I craved—all kinds of non-food items routinely ended up in my mouth. Years later, while reading the book White is for Witching by Helen Oyeyemi for a university course, I would finally discover that my need to eat things had a name: pica.
I’ve been consuming items that aren’t food since I was a toddler eating sand. After entering school, I switched to pencils and erasers. I once had a plaid teddy bear; on its head was a little loop of material that could be used to hang the bear up. There’s a photo of me in my kindergarten classroom with the bear hanging from my mouth, chewing away on the loop. I also have an oversized comfortable jacket I stole from my dad when I was young, the corners of the collar chewed off to reveal the fluffy stuffing inside. I loved the feeling and taste of cotton fibers — they were so chewy, and I enjoyed pulling them out one thread at a time.
I remember the hot shame and guilt I felt when people caught me in the act — when yet another teacher told me to take that pencil out of my mouth, or when my best friend shot me disgusted looks as I chewed on a pink eraser until it disappeared. I would mumble words while gnawing on small bits of plastic at the back of my mouth; if people asked what I was eating, I’d panic and swallow. Once people tried to keep me from eating things, I started to slip items into my pockets to eat later when no one was around.
When my mom told me to stop relentlessly chewing my hair, I began hiding behind books or my hands so she wouldn’t catch me in the act. Over time, I started cutting my hair shorter and shorter to keep it away from my mouth; when I decided to grow it out past my shoulders during the first year of university, I couldn’t help but pull out chunks of hair again to chew. A few months later, I cut it off into a short undercut, putting the hair safely out of my mouth’s reach once and for all.
No matter what I ate, there was a ritual to it, a process, that drew me in; each different substance had to be consumed a different way. I was careful to follow those rituals, whether it was slowly tearing strips off the Archie comic paper, or biting off tiny pieces of plastic and chewing them until they were malleable and could be swallowed.
When people think of eating disorders, they typically think of anorexia and bulimia. But millions struggle every day with other, lesser known disorders, like Ruminating Disorder (which involves people re-chewing regurgitated food) and Orthorexia (an obsession with proper or “healthful” eating).
Among these little-known disorders is pica, described by NEDA as “an eating disorder that involves eating items that are not typically thought of as food and that do not contain significant nutritional value, such as hair, dirt, and paint chips.” The disorder only encompasses items, NEDA emphasizes, that are not part of “culturally supported or socially normative practice (e.g., some cultures promote eating clay as part of a medicinal practice).”
The roots of pica are varied. For some, the disorder is rooted in a need to correct a nutritional deficiency; iron-deficiency anemia and malnutrition are listed by NEDA as the two of the most common causes of pica, and this can cause pregnant women, too, to develop it. Pica has additionally been linked to autism spectrum disorder, intellectual disability, and schizophrenia, as well as trichotillomania (hair pulling disorder) and excoriation (skin picking) disorder.
Whatever the cause or risk factor, a lack of understanding about pica means many face stigmatization, and are unable to find help if they need it. This is especially concerning considering the condition seems to be growing in prevalence; one study found that hospitalizations for pica jumped a staggering 93% between 1999 and 2009.
Hospitalizations for pica in a 10-year span jumped a staggering 93%.
Health consequences include mechanical bowel problems, infections such as toxoplasmosis and toxocariasis, intestinal obstruction, and poisoning. In rare cases, it has even led to death. (In one documented case, a man died after consuming five kilograms of coins, necklaces, and needles; in another case, a man passed away after swallowing 10 buttons, a drawing pin, pieces of chain and bone, and a large amount of black foam rubber.)
Treatment varies depending on the circumstance. NEDA suggests first testing for mineral or nutrient deficiencies and correcting those; if that doesn’t work, it recommends turning to behavioral interventions.
My own recovery process hasn’t been easy — but it’s put me in a much better place now.
When I spoke with my mom to write about my experiences, she thought my pica stopped by the time I was 10 or so. In truth, I struggle even now.
I still put things in my mouth — like bottle caps and plastic earring backs — but for the most part, I just chew on them without swallowing. I’ve also started eating raw potatoes and raw pasta, which emulate the taste of non-food items. And to mimic what it’s like to break down dense, hard plastic through chewing, I’ve shoved handfuls of unpopped popcorn into my cheeks, moving the kernels around my mouth and grinding them into powder.
What’s really helped me is identifying the root of my pica: anxiety. Ritualistically chewing non-food items, I’ve realized, helps me feel in control when my mental state does the opposite. Since then, I’ve taken the time to manage my anxiety in healthy ways; with this progress, I’ve become less inclined to consume paper, or erasers, or strands of my own hair.
Eating disorder recovery is rarely linear, and I sometimes still eat non-food items, especially when I’m feeling particularly anxious. But these days, more often than not, my Archie comics remain just for reading.
If you think you might need help for pica or any other eating disorder, call the NEDA helpline at (800) 931–2237.