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:

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.