‘I will eat anything’ pica

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Trigger Warning:  Pica, a highly dangerous less known eating disorder.  The content in this article may be triggering for some readers. We share this article for information purpose only.

 

The name: “Pica” comes from the Latin word for magpie, a bird known for its large and random appetite.

Consultant psychiatrist Prof Dr Ramli Musa from the International Islamic University Malaysia said pica is classified as an eating disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

When someone thinks of an eating disorder, the “big three” – Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder – most often come to mind. What many don’t realize is that there are several other clinically recognized feeding and eating disorders. One of these diagnoses is a complex and lesser understood condition called Pica.

Pica is defined as the persistent and compulsive eating, over a period of at least one month, of non-food substances (such as paint or string) that are not developmentally appropriate for that age. It usually develops in childhood and often only persists for a few months.

Pica is common among children with developmental disabilities which can make the condition more difficult to treat or manage. An appropriate diagnosis of Pica does not include the consumption of non-food items that are ingested as part of a culturally supported and/or socially normative practice, such as eating clay for medicinal purposes.

 

Dear Readers,

 

Please find below an article on Pica Eating Disorder from Malaysia. This article is taken from the star online. We share this article for information only.

 

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‘I will eat anything’

Not food: Eating glass can be a symptom of pica, and is dangerous as it can cause internal injuries.

Not food: Eating glass can be a symptom of pica, and is dangerous as it can cause internal injuries.

By Clarissa Chung

 

 

PETALING JAYA: We know not to take it literally when someone tells us they “will eat anything”, but there are some people who actually do.

They are those with pica, a psychiatric condition in which people ingest items that are not typically thought of as food and which do not contain significant nutritional value.

Such items include hair, dirt, pebbles, paint chips, clay, chalk and paper.

Consultant psychiatrist Prof Dr Ramli Musa from the International Islamic University Malaysia said pica is classified as an eating disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Having peculiar eating habits, especially in young children, does not necessarily mean one has pica.

What is pica?

According to Prof Ramli, the diagnosis of pica is made mainly based on the presence of persistent eating habits of non-nutritive substances, like the examples given above, for a period of at least a month.

The US-based National Eating Disorders Association (Neda) also stated that pica is not diagnosed if the ingesting of such substances is part of a socially normal practice.

For instance, some cultures promote eating clay as part of a medicinal practice.

Prof Ramli also stressed that a toddler’s act of putting objects into his or her mouth does not necessarily indicate pica.

“It is common for children to put objects into their mouths as a form of exploring their surroundings.

“Such actions, like thumbsucking, may also be caused by anxiety.
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“In such cases, it is not considered as being a pica disorder,” he said.

Therefore, in order to exclude developmentally-normal mouthing, children under two years of age should not be diagnosed with pica, according to Neda.

Prof Ramli said the onset of the disorder is commonly in the paediatric age group, with adult onset being rare, but still possible.

“If the onset is in childhood, it could be prolonged into adulthood if no psychological intervention is done,” he said, adding that mild cases of pica may be resolved naturally and symptoms may fade over time.

He explained that those with mild cases of pica may simply be seeking to obtain self-gratification by eating non-food objects.

In severe cases, he said, patients may eat dangerous objects that could endanger their lives and health, such as scissors or needles.

“The problem arises when the objects they ingest cause serious health issues such as bowel blockage, bowel perforation and toxic effects.

“In such cases, the blockage of intestines would lead to surgical intervention.”

Treatment and cause

Prof Ramli said that cognitive behavioural therapy (CBT) could correct the patient’s wrong belief that eating non-food materials is beneficial.

“However, people with severe pica would require some form of medication in order to treat and manage the disorder,” he said.

Antipsychotic drugs, he added, may also be useful in severe cases as pica is associated with having wrong beliefs or delusions.

 

 

Prof Ramli: Pica typically starts during childhood, although it is possible to occur for the first time in an adult.

Prof Ramli: Pica typically starts during childhood, although it is possible to occur for the first time in an adult.

He also said that treatment runs more easily and with better results if there is the cooperation and involvement of family members.

As to what causes pica disorder, Prof Ramli said there is no single cause, although there are some risk factors that may cause a person to be predisposed to developing it.

“Both genetic and environmental factors contribute to the development of pica,” he said, adding, however, that environmental factors play a relatively more important role than genetics.

“Environmental factors could include emotional distress, anxiety and a rigid parenting style.

“A rigid or authoritarian parenting style has been reported as being the predisposing factor to any eating disorder.

“The behaviour of eating non-nutritious objects may be viewed as a form of retaliation to the rigidity of such a parenting style,” he explained.

Neda states between 4% and 26% of institutionalised individuals are believed to have pica.

However, Prof Ramli said there is no large population-based study done in Malaysia to determine the prevalence of any eating disorders, including pica.

“The incidence of such eating disorders have been reported as individual case reports,” he said.

He noted that the need to invest effort in research of the disorder may not be as compelling as other more common mental disorders.

“This is because the incidence of pica is rare and the impact of the condition is relatively small on society.

“The study of the disorder may be limited to case studies as a starting point,” he said.

 

 

 

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Islam and Eating Disorders founded in 2012 – run by Maha Khan, the blog creates awareness of Eating Disorders in the Muslim world, offers information and support for sufferers and their loved ones.

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