Pica – Cravings to the Extreme

Defined as the consumption and craving of nonfood items over a period longer than a month, pica is a disorder that many may find overly bizarre and unrelatable. This disorder may also be best known to the public from its heavy coverage on the TLC show, My Strange Addiction, which follows individuals with com­pulsive and “unusual” behaviours, such as pica. However, these widely documented cases of the compulsive eating of objects such as toilet pa­per, cosmetics, and air freshener, may arise from reasons more complex than just liking their taste or texture.

While pica behaviour is largely seen in pregnant women, children, and people with developmental disorders, it has also been associated with psy­chological stress stemming from famil­ial and parental issues and emotional trauma. Other proposed causes of pica include gastrointestinal distress and obsessive-compulsive spectrum disor­der, with the consumption of nonfood items acting as a method to soothe or reduce physical or mental discomfort.

In some places, pica behaviour may be normalized, such as in the state of Georgia in the United States of America, where consumption of ka­olin, or white clay, by African-Amer­ican women is considered a cultural practice. Kaolin is also consumed widely in Africa and is thought to relieve nausea and gastrointestinal symptoms caused by early pregnancy.

Furthermore, association studies of individuals that exhibit pica be­haviour have found that this disor­der is correlated with anemia, low hemoglobin, and iron and zinc defi­ciencies, making the cause (or causes) behind this disorder more compli­cated than it might initially appear.

And while it might seem obvious, the consequences of pica can be quite severe. Consumption of materials such as broken glass can cause internal in­juries while ingestion of dirt in areas where pesticides or other toxic envi­ronmental pollutants can be found can lead to poisoning. However, treat­ment of pica can be quite complex, and it is important to determine the cause of a patient’s pica behaviour.

In children, pica is often treated by alerting the parents and ensuring that the child is under heavier supervision to prevent any attempts to eat non-food items. Another strategy involves ig­noring the behaviour if the motivation is to seek attention or to find an alternative to the non-food item if the patient ingests this item for a sen­sory reason. Other treatments include therapy, the prescription of psychiatric medicine, and taking certain nutri­tional supplements because, as previ­ously stated, pica is shown to be as­sociated with iron or zinc deficiencies.

The range of pica behaviour can be as harmless as chewing ice cubes or chips to such extremes as regularly in­gesting the material of bikes, television sets, and even planes in the case of Michel Lotito of France, also known as Monsieur “Mouth” Mangetout or Mr. Eat-All in En­glish. From a young age, Lotito found that he preferred to ingest non-food materials and medical examination revealed that he had un­usually strong stomach acids and thick gastrointestinal tract linings, which helped facilitate his pica behaviour.

[…pica is a serious and sometimes life-threat­ening condition that should be regarded with empathy and understanding.]

Lotito went on to become an en­tertainer with his act being the con­sumption of absurd items, even once consuming an entire Cessna 150 air­craft over the course of two years! And while it may seem difficult, or even impossible to chew or swallow all the materials found in an airplane, Lotito has a strategy to indulge his odd cravings—he breaks them apart into bits that he can swallow and drinks mineral oil to ensure everything goes down smoothly. With this routine, Lotito was awarded with the record for the ‘strangest diet’ in the Guin­ness Book of Records. He even re­ceived a plaque in commemoration of this, however, quite fittingly, he ate it.

Lotito passed in 2007 at age 57 of natural causes, almost 30 years after consuming the Cessna, with no cas­es of pica so extreme since. However, more bizarre historical accounts of pica and unusual appetites include the story of a man known as Tarrare, who lived in the late 1700s. While Tarra­re exhibited regular pica behaviours, such as ingesting corks and stones for entertainment, his other consumption habits were objectionable at best and abhorrent at worst. Tarrare would swallow whole, live animals, such as cats, eels, and lizards, and in a stay at a hospital, he was caught attempting to drink blood from bloodletting patients and to eat corpses from the morgue. He was even suspected in the disap­pearance of a 14monthold baby and was quickly removed from the hospi­tal as a result of this.

When he later died of tuberculosis, it was found that Tarrare’s esophagus was incredibly wide and that his body was full of pus. This aligns with the fact that in life, he was known for his largely distended mouth and abdomen and terrible odour that reportedly worsened after he ate. In his time, it was impossible to determine any underlying causes for his unusual appetite so we only know him now as one of the most bizarre and harrow­ing stories of pica and polyphagia.

However, these two cases are an anomalous extreme and patients with pica should not be viewed as exhibits in a freak show, which the television pro­gram My Strange Addiction has long been criticized as doing. Instead, it is important to recog­nize, that although potentially strange to those unfamiliar with it, pica is a serious and sometimes life-threaten­ing condition that should be regard­ed with empathy and understanding.

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References

1.https://www.psychiatrictimes.com/view/update-pica-prevalence-contributing-causes-and-treatment

2.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2850349/

3.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113508/

4.https://www.nydailynews.com/entertainment/tv-movies/strange-addiction-delivers-big-grosses-article-1.1279987

5.https://www.ripleys.com/weird-news/mangetout/

6.https://www.youtube.com/watch?v=-rLl7E_sIpc

7.https://www.ripleys.com/weird-news/tarrare/