Get access

Pica and rumination behavior among individuals seeking treatment for eating disorders or obesity

Authors

  • Charlotte B. Delaney BA,

    1. Albert Einstein College of Medicine, Yeshiva University, Bronx, New York
    2. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts
    Search for more papers by this author
  • Kamryn T. Eddy PhD,

    1. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts
    2. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
    Search for more papers by this author
  • Andrea S. Hartmann PhD,

    1. Insititute for Psychology, University of Osnabrück, Germany
    Search for more papers by this author
  • Anne E. Becker MD, PhD,

    1. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts
    2. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
    3. Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
    Search for more papers by this author
  • Helen B. Murray BA,

    1. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts
    Search for more papers by this author
  • Jennifer J. Thomas PhD

    Corresponding author
    1. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts
    2. Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
    • Correspondence to: Jennifer J. Thomas, Ph.D., Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 2 Longfellow Place, Suite 200 Boston, MA 02114. E-mail: jjthomas@mgh.harvard.edu

    Search for more papers by this author

  • Disclosure: The authors disclosed no proprietary or commercial interest in any product mentioned or concept discussed in this article.

  • Previous Presentation: These data were included in a poster presentation at the 2013 Eating Disorder Research Society meeting in Bethesda, MD.

Abstract

Objective

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.

Method

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).

Results

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.

Discussion

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)

Ancillary