Disclosure: The authors disclosed no proprietary or commercial interest in any product mentioned or concept discussed in this article.
Pica and rumination behavior among individuals seeking treatment for eating disorders or obesity
Article first published online: 11 APR 2014
© 2014 Wiley Periodicals, Inc.
International Journal of Eating Disorders
Volume 48, Issue 2, pages 238–248, March 2015
How to Cite
Delaney, C. B., Eddy, K. T., Hartmann, A. S., Becker, A. E., Murray, H. B. and Thomas, J. J. (2015), Pica and rumination behavior among individuals seeking treatment for eating disorders or obesity. Int. J. Eat. Disord., 48: 238–248. doi: 10.1002/eat.22279
Previous Presentation: These data were included in a poster presentation at the 2013 Eating Disorder Research Society meeting in Bethesda, MD.
- Issue published online: 9 FEB 2015
- Article first published online: 11 APR 2014
- Manuscript Accepted: 11 MAR 2014
- Manuscript Revised: 6 MAR 2014
- Manuscript Received: 31 DEC 2013
- Office of Medical Student Research of the Albert Einstein College of Medicine and Hilda and Preston Davis Foundation
- eating disorder;
- feeding disorder
Pica and rumination disorder (RD)—formerly classified within DSM-IV Feeding and Eating Disorders of Infancy or Early Childhood—are now classified within DSM-5 Feeding and Eating Disorders. Though pica and RD have been studied in select populations (e.g., pregnant women, intellectually disabled persons), their typical features and overall prevalence remain unknown. This study examined the clinical characteristics and frequency of DSM-5 pica and RD among individuals seeking treatment for eating disorders and obesity.
We conducted structured interviews with adolescent and young adult females from a residential eating disorder center (N = 149), and adult males and females with overweight or obesity from an outpatient weight-loss clinic (N = 100).
Several participants reported ingesting non-nutritive substances (e.g., ice) for weight-control purposes. However, only 1.3% (n = 2; 95% CI: .06% to 5.1%) at the residential eating disorder center and 0% at the weight-loss clinic met DSM-5 criteria for pica, consuming gum and plastic. Although no eating disorder participants were eligible for an RD diagnosis due to DSM-5 trumping rules, 7.4% (n = 11; 95% CI: 4.0% to 12.9%) endorsed rumination behavior under varying degrees of volitional control. At the weight-loss clinic, 2.0% (n = 2; 95% CI: 0.1% to 7.4%) had RD.
DSM-5 pica and RD were rare in our sample of individuals seeking treatment for eating disorders and obesity, but related behaviors were more common. The wide range of pica and rumination presentations highlights the challenges of differential diagnosis with other forms of disordered eating. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:238–248)