Hi, I understand the distress you are going through. Pica can be a result of nutritional deficiency like iron deficiency anemia, zinc deficiency, etc., or can occur as part of impulse control disorder. In your case, your Hb level is low which might be the effect as well as cause of pica. Eating cement is definitely not healthy and can cause multiple gastrointestinal problems and other physical problems. Your joint pain and swelling can be due to toxic materials contained in cement being accumulated in your body. I would suggest that you seek a orthopedic consultation for evaluation of joint pain and swelling and get treated accordingly. In addition, your hemoglobin levels need to be corrected with iron, folic acid and vitamin B12 supplementation. You should consult a psychiatrist as soon as possible for help in control in your behavior. In case the behavior continues even after correction of nutritional deficiencies, treatment with drugs like selective serotonin reuptake inhibitors (like escitalopram/ sertraline) can be helpful. More importantly, behavior therapy (habit reversal therapy specifically) will be highly recommended. Behavior therapy generally offers better results than drugs per say. It will consist of sessions which will help in controlling the impulse of eating cement or resisting it. I do hope that I was able to answer your query. Wish you all the best.