Treatment for pica may vary by patient and suspected cause (e.g., child, developmentally disabled, pregnant or psychogenic) and may emphasize psychosocial, environmental and family-guidance approaches, (iron deficiency) may be treatable though iron supplement through dietary changes. An initial approach often involves screening for and, if necessary, treating any mineral deficiencies or other comorbid conditions. For pica that appears to be of psychogenic cause, therapy and medication such as SSRIs have been used successfully. However, previous reports have cautioned against the use of medication until all non-psychogenic causes have been ruled out.

Looking back at the different causes of pica related to assessment, the clinician will try to develop a treatment. First, there is pica as a result of social attention. A strategy might be used of ignoring the person’s behavior or giving them the least possible attention. If their pica is a result of obtaining a favorite item, a strategy may be used where the person is able to receive the item or activity without eating inedible items. The individual’s communication skills should increase so that they can relate what they want to another person without engaging in this behavior. If pica is a way for a person to escape an activity or situation, the reason why the person wants to escape the activity should be examined and the person should be moved to a new situation. If pica is motivated by sensory feedback, an alternative method of feeling that sensation should be provided. Other non-medication techniques might include other ways for oral stimulation such as gum. Foods such as popcorn have also been found helpful. These things can be placed in a “Pica Box” that should be easily accessible to the individual when they feel like engaging in pica.

Behavior-based treatment options can be useful for developmentally disabled and mentally ill individuals with pica. Behavioral treatments for pica have been shown to reduce pica severity by 80% in people with intellectual disabilities. These may involve using positive reinforcement normal behavior. Many use aversion therapy, where the patient learns through positive reinforcement which foods are good and which ones they should not eat. Often treatment is similar to the treatment of obsessive compulsive or addictive disorders (such as exposure therapy). In some cases treatment is as simple as addressing the fact they have this disorder and why they may have it. A recent study classified nine such classes of behavioral intervention: Success with treatment is generally high and generally fades with age, but it varies depending on the cause of the disorder. Developmental causes tend to have a lower success rate.

Treatment techniques include:

Pagophagia is the compulsive consumption of ice or iced drinks.

It is a form of the disorder pica. It has been associated with iron deficiency anemia, and shown to respond to iron supplementation,

leading some investigators to postulate that some forms of pica may be the result of nutritional deficiency. Chewing ice may lessen pain in glossitis related to iron deficiency anemia. However, the American Dental Association recommends not chewing ice because it can crack teeth; instead ice should be allowed to melt in the mouth.

Folk wisdom (and some early investigators) maintained that pica reflected an appetite to compensate for nutritional deficiencies, such as low iron or zinc. Some forms of pica (as in pregnant women who are iron deficient) can be treated by supplementing the nutrient.

Later research has demonstrated that the substances ingested generally do not provide the mineral or nutrient in which patients are deficient. As the people start eating nonfoods, pica can also cause the nutritional deficiencies with which it is associated. In one case study, pagophagia was reported to "cause" iron deficiency anemia. At the same time, however, the researchers suggested that chewing ice may benefit stomatitis and glossitis. The nutrients obtained from nonfoods such as soil or ice will vary widely depending on geographic location. For example, ice made from hard water will contain more minerals, especially calcium and magnesium, but simply drinking the water will provide the same minerals.

The word derives from Greek: pagos, frost, + phagō, to eat.

Blood transfusion is sometimes used to treat iron deficiency with hemodynamic instability. Sometimes transfusions are considered for people who have chronic iron deficiency or who will soon go to surgery, but even if such people have low hemoglobin, they should be given oral treatment or intravenous iron.

Before commencing treatment, there should be definitive diagnosis of the underlying cause for iron deficiency. This is particularly the case in older patients, who are most susceptible to colorectal cancer and the gastrointestinal bleeding it often causes. In adults, 60% of patients with iron deficiency anemia may have underlying gastrointestinal disorders leading to chronic blood loss.

It is likely that the cause of the iron deficiency will need treatment as well.

Upon diagnosis, the condition can be treated with iron supplements. The choice of supplement will depend upon both the severity of the condition, the required speed of improvement (e.g. if awaiting elective surgery) and the likelihood of treatment being effective (e.g. if has underlying IBD, is undergoing dialysis, or is having ESA therapy).

Examples of oral iron that are often used are ferrous sulfate, ferrous gluconate, or amino acid chelate tablets. Recent research suggests the replacement dose of iron, at least in the elderly with iron deficiency, may be as little as 15 mg per day of elemental iron.

Pica is characterized by an appetite for substances that are largely non-nutritive, such as ice (pagophagia); hair (trichophagia); paper (xylophagia); drywall or paint; metal (metallophagia); stones (lithophagia) or soil (geophagia); glass (hyalophagia); or feces (coprophagia); and chalk. According to DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) criteria, for these actions to be considered pica, they must persist for more than one month at an age where eating such objects is considered developmentally inappropriate, not part of culturally sanctioned practice and sufficiently severe to warrant clinical attention. It can lead to intoxication in children, which can result in an impairment of both physical and mental development. In addition, it can also lead to surgical emergencies due to an intestinal obstruction as well as more subtle symptoms such as nutritional deficiencies and parasitosis. Pica has been linked to other mental and emotional disorders. Stressors such as emotional trauma, maternal deprivation, family issues, parental neglect, pregnancy, and a disorganized family structure are strongly linked to pica as a form of comfort.

Pica is most commonly seen in pregnant women, small children, and those with developmental disabilities such as autism. Children eating painted plaster containing lead may suffer brain damage from lead poisoning. There is a similar risk from eating soil near roads that existed before tetraethyllead in petrol was phased out (in some countries) or before people stopped using contaminated oil (containing toxic PCBs or dioxin) to settle dust. In addition to poisoning, there is also a much greater risk of gastro-intestinal obstruction or tearing in the stomach. Another risk of eating soil is the ingestion of animal feces and accompanying parasites. Pica can also be found in other animals and is commonly found in dogs.

When treating iron-deficiency anemia, considerations of the proper treatment methods are done in light of the "cause and severity" of the condition. If the iron-deficiency anemia is a downstream effect of blood loss or another underlying cause, treatment is geared toward addressing the underlying cause when possible. In severe acute cases, treatment measures are taken for immediate management in the interim, such as blood transfusions or even intravenous iron.

Iron-deficiency anemia treatment for less severe cases includes dietary changes to incorporate iron-rich foods into regular oral intake. Foods rich in ascorbic acid (vitamin C) can also be beneficial, since ascorbic acid enhances iron absorption. Other oral options are iron supplements in the form of pills or drops for children.

As iron-deficiency anemia becomes more severe, or if the anemia does not respond to oral treatments, other measures may become necessary. In addition to the previously mentioned indication for intravenous iron or blood transfusions, intravenous iron may also be used when oral intake is not tolerated, as well as for other indications. Specifically, for those on dialysis, parenteral iron is commonly used. Individuals on dialysis who are taking forms of erythropoietin or some "erythropoiesis-stimulating agent" are given parenteral iron, which helps the body respond to the erythropoietin agents and produce red blood cells.

The various forms of treatment are not without possible adverse effects. Iron supplementation by mouth commonly causes negative gastrointestinal effects, including constipation. Intravenous iron can induce an allergic response that can be as serious as anaphylaxis, although different formulations have decreased the likelihood of this adverse effect.

It is unclear if screening pregnant women for iron-deficiency anemia during pregnancy improves outcomes in the United States. The same holds true for screening children who are "6 to 24 months" old.