Everything You Need To Know About Pica

A surprising number of people suffer from this disorder.


Cally Silberbauer |

Woman’s Health recently posted a picture of “soil” (a chunk of hard sand) on Instagram and asked: “Have you ever eaten a sand rusk?” Turns out, a bunch of SA women have. Some simply love it, others do it for cultural reasons… but some actually crave it – and don’t know how to stop.

We spoke to one of our followers, Zanele Mkhize, who had commented on the original post, and she filled us in. Zanele grew up surrounded by people who enjoyed eating “sand rusks”. In Zulu, these rusks are called umcako. Zanele was introduced to umcako by her mother, who used it as a treatment for her upset stomach. From then on she would eat a rusk whenever her mother brought them home.

But does it taste good? We couldn’t help wondering. Zanele enlightened us. For her, the umcako is quite flavourless, but the texture is enjoyable. Umcako are easy to get your hands on. Street vendors sell blocks of soil for R10 each. Zanele has since given up “sand rusks” as it can have medical implications and, luckily, has experienced zero cravings since. As she put it, she is officially “soil rusk clean”. She never experienced any side effects, however, when she did enjoy the occasional umcako.

The eating of non-food items (I think we can agree that a “sand rusk” is not actually food) is a condition known as pica, and we sought some medical advice to find out why people develop the urge to eat sand. 

READ MORE: “I Suffered From An Eating Disorder You’ve Never Heard Of Before”

Pica is a condition where a person gets addicted to eating non-food items. Beyond sand, it can include other seemingly random things like ice, ash, coal, soap, metal, hair, to name a few. Besides being a norm in some cultures, it can also be put down to stress, mental health disorders or malnutrition. This condition is not necessarily harmful, but this also depends on what non-food substance is consumed…

So, What Causes Pica?

This is a question I asked Dr Janine Silberbauer and there are actually a few reasons.

Firstly, pica can be diagnosed as a psychiatric disease or mental disorder. In order for pica to be diagnosed as such, four criteria must be met, says Silberbauer.

  1. The persistent eating of non-food substances for a period lasting at least one month.
  2. The consumption is developmentally inappropriate. In other words, you’re out of nappies, so you should know better than to eat the paint off the walls. Babies are known to put anything and everything in their mouths, but if you’re still doing this at the ripe old age of 27, we call it pica.
  3. The behaviour is not part of a cultural or social norm. In some cultures, the eating of certain substances is considered cultural practice and therefore does not form part of a psychiatric eating disorder.
  4. If this condition occurs in the context of another mental disorder (anorexia nervosa, mental retardation, schizophrenia, or autism, to name a few) where it can develop as a kind of coping mechanism.

READ MORE: 5 Signs You Might Have A Serious Vitamin B12 Deficiency

Secondly, pica can be brought on by nutrient deficiency. Low nutrient levels can be caused by an unbalanced diet that lacks the required minerals for your body to function. Lifestyles such as vegetarianism and veganism can lead to lowered iron and zinc levels, so monitor your diet.

Pregnancy does a lot of weird things to our bodies – and pica can be one of them. Women often experience strange cravings when they’re pregnant and the underlying reason is often a deficiency of nutrients. If you are pregnant, your doctor should be monitoring your nutritional levels carefully.

Lastly, as mentioned before, pica can be considered a cultural norm. In certain cultures, eating sand rusks is completely normal. Zanele shared some of her knowledge on the subject with us. In Zulu culture, the eating of umcako dates back many years. It’s also used in traditional practices; for example, when girls become of age. The umcako will be softened with water and then painted onto the girl’s faces, arms and legs. In other cultures, some non-food items are also believed to enhance fertility and help ease nausea during pregnancy. Eating soil can also be linked to religious practices.

How To Treat Pica

Now that we know why it happens, is it a problem? And if so, how should it be treated?

The main concern, says Silberbauer, is when the substance consumed is harmful. For example, paint and soil can contain lead and lead to lead poisoning. Eating soil can also expose you to parasites, roundworms and hookworms. Never a fun experience, obviously.

To treat pica, the cause needs to be addressed. If you have a nutritional deficiency, then your diet needs to be altered so that all nutritional needs met. A zinc and iron deficiency can be remedied with iron pills and the correct diet. If you aren’t a meat-eater, then make sure you eat foods rich in zinc and iron, such as pumpkin seeds, mushrooms, spinach and dark chocolate (yep, you heard right).

If pica is diagnosed as a mental disorder, it should be treated as such. Behavioural shaping treatments can be used, such as positive reinforcement (praising when not eating the substance).

If you are a rock-biter or an ice-muncher and the addiction is real, make sure you look into what is causing it and proceed with caution. Chat to a doctor. Preferably, switch those rocks to rock cakes and ditch the habit.

READ MORE ON: Health Health Advice Health Conditions Pica