The human body has two glands in front of the ears called parotid glands. These glands produce saliva, which is primarily to help a person chew and digest food.
When a person with bulimia purges, they can agitate these glands over time. Eventually, this can cause these glands to become swollen, causing puffiness.  This swelling is called sialadenosis, and it is not exclusively caused by bulimia, although bulimia is the most common cause in developed western nations. 
Does ‘Bulimia Face’ Represent a Health Concern?
If a person is experiencing swelling as a result of purging, it has the potential to impact their quality of life and potentially cause discomfort. Sometimes, this swelling can cause pain, and it can also significantly alter a person’s facial aesthetic.
Some people who struggle with bulimia for a long time may experience particularly severe swelling, although the most severe concern regarding this swelling is generally the aesthetic changes it causes.  It is not usually dangerous, although it may significantly affect a person’s self-image and the way they socially interact.
It is also not the only health symptom a person is likely to experience if they struggle with bulimia. The eating disorder is associated with a number of detrimental symptoms besides swelling of the parotid glands.
Can You Reverse Swelling Caused by Bulimia?
It is possible to reverse swelling caused by bulimia, but a person will usually need to see a doctor to do so. The standard treatment is prescribing the medication pilocarpine, which increases the amount of saliva the body produces and helps to combat sialadenosis in patients with bulimia. 
In the long term, it will also be important that a person seeks mental health treatment for their bulimia. Left untreated, continued purging may cause this problem to recur, as well as cause a person’s health to deteriorate due to malnourishment. Many people who have bulimia also struggle with other related issues, such as anxiety and depression, which mental health treatment can also treat.
Bulimia Treatment Options
The first step to recovering from bulimia is admitting there is a problem. Once a person is able to do that, they can enroll in treatment.
Many people may benefit from a combination of treatments. Treatment may consist of the following:
- Nutritional counseling: In this kind of treatment, a person works with an expert to develop a healthy diet and resist bingeing and purging behaviors. The nutritional therapist ensures their nutritional needs are met through a healthy, balanced diet.
- Cognitive behavioral therapy: The person works with a therapist to improve their sense of self-worth and how they view their body. In sessions, they aim to identify and learn to control negative emotions in order to prevent damaging behaviors.
- Medications: While medications cannot treat bulimia directly, they can help to combat contributing mental health issues, such as depression. 
People with severe symptoms, such as those who may also have anorexia, can potentially benefit from inpatient programs. In these comprehensive programs, a person spends multiple weeks at a treatment facility getting more focused care so they can physically and mentally recover to a point where they can better handle the daily pressures of everyday life. While bulimia is a serious condition, it is very treatable.
- The Hospital for Sick Children. (2016, February 2). Bulimia nervosa: Signs and symptoms. AboutKidsHealth.
- University of Iowa Carver College of Medicine. (2019, April 15). Sialosis or Sialadenosis of the Salivary Glands. University of Iowa Health Care.
- Garcia, B., Dean Ferrer, A., Diaz Jimenez, N., Alamillos Granados, F. J. (2018). Bilateral Parotid Sialadenosis Associated with Long-Standing Bulimia: A Case Report and Literature Review. Journal of Maxillofacial and Oral Surgery, 17(2), 117-121.
- National Library of Medicine. (2016, September 15). Pilocarpine. MedlinePlus.
- The President and Fellows of Harvard College. (2014, December 19). Bulimia: Symptoms, Diagnosis and Treatments. Harvard Medical School.