Health Tips

Did you know that chewing ice is an eating disorder?

Pica. It does sound like a cute name for pikachu but unfortunately it is the name of an eating disorder. Heard of people eating mud cakes? That is called Pica. 

Pica is 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. 

Pica is a condition seen all over the world, in some third world countries people resort to eating mud cakes and soil when food is scarce or unavailable. Other conditions where we see people with Pica are iron-deficiency anemia or malnutrition (the 2 most common causes), people with mental health disorders associated with impaired functioning (intellectual disability, schizophrenia, autism spectrum disorder) and pregnancy. I hate to break it to you but eating or chewing on Ice persistently over a period of time (pagophagia) is also categorised under pica and the most common form of pica as well. Pica is a sign that the body is trying to compensate for nutritional deficiency in the two most common causes. 

Other substances that people with Pica consume:

• Paper, Chalk, Paint

• Soap, Hair

• String, Wool

• Soil, Pebbles, Charcoal, Ash, Clay

• Talcum powder, Gum

• Metal, Starch

What should I do if I am addicted to eating ice?

Well, firstly see a doctor to check for the 2 most common causes. Your doctor will test for mineral and nutritional deficiencies and treat them accordingly. Once treated, one will usually stop eating ice. If the above does not help, then behavioral interventions play a role to help stop this eating disorder.

If you know someone who has autism spectrum disorder with pica, the treatment would be slightly different where it involves conscious effort to redirect his or her direction away from that particular object and rewarding them.

What is the relationship between iron deficiency anemia and eating ice?

Hunt et al. hypothesized that chewing ice triggers vascular changes that lead to preferential or increased perfusion of the brain. They did a neuropsychological test on both non-anemic and anemic patients and found that chewing ice significantly improves the anemic group performance while it made no difference to the non-anemic group. And this result is not seen when ice was replaced with cold water. They reasoned that this could occur due to peripheral vasoconstriction which in turn increases blood flow to the brain. Anemic patients have low blood count which results in poorer oxygen perfusion as blood is needed to carry the oxygen to every cell in our body including our brain. Therefore, anemic patients usually presents with lethargy besides the usual pale skin and other signs. 

Why am I anemic?

While there are many types of anemia, we will look solely at iron deficiency anemia here.

• Lack of iron in one’s diet like the name suggests. The food we consume matters as well as the amount. Eating more iron rich food will help overcome this. Some examples are meat, eggs, leafy green vegetables and iron-fortified foods.

• Blood loss. Loss of blood drastically or consistently over a period of time would also cause anemia. This could be due to heavy menstruation, chronic loss (peptic ulcer, colorectal cancer, colon polyp, hiatal hernia) or gastrointestinal bleeding (long term use of aspirin is common)

• Inability to absorb iron. This is seen in patients who underwent gastric bypass surgery or removed part of their small intestines. Iron and other nutrients in the body would pass by the gastrointestinal tract faster than usual preventing the absorption and there would be lesser surface area for absorption as well post surgery. Some intestinal disorders can decrease the ability to absorb iron as seen in celiac disease. 

• Pregnancy. Almost all pregnant mothers are encouraged to take iron supplements as the state of pregnancy itself demands more iron with the increasing blood volume and the iron storage depletes faster as the foetus in the womb needs haemoglobin as well. 

How does chewing ice damage your teeth?

• Cracked and chipped teeth

• Damage to tooth enamel

• Problems with existing dental work such as fillings and crowns

• Sore jaw muscles

• Your teeth may become extremely sensitive to hot and cold drinks and foods

• More prone to cavities

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Reference :

1. https://www.dentalplans.com/dental-information/dental-concerns/ice-chewing-damage

2. https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/pica

3. https://www.sciencedirect.com/science/article/abs/pii/S0306987714002710

4. https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034

Picture credit :

1. https://www.visiondentalclinic.com/bad-habits-that-wreck-your-teeth/

2. https://parenting.firstcry.com/articles/pica-in-children-causes-symptoms-treatment/

3. https://www.optimallivingdynamics.com/blog/21-proven-ways-to-increase-brain-blood-flow

4. https://www.pathkindlabs.com/blog/iron-deficiency-anaemia-symptoms-and-causes

5. https://www.123dentist.com/sensitive-teeth-common-causes-and-solutions/

6.  

Written By

Dr. Jessamine Chong Sze Lynn

Reviewed By

Doc2us Medical Board