The Effects of Bulimia on the Parotid Gland 

It’s an eating disorder characterized by repeated purging, which can cause these glands to swell to produce more saliva to protect the delicate tissue inside the mouth. This can change the shape of the face and may cause other health complications.

The self-induced vomiting that characterizes purging-type bulimia nervosa (BN) can cause salivary gland enlargement. They increase in size because they are strained and need to make more saliva to protect the inside of the mouth from repeated exposure to stomach acid, which is very caustic.

The enlarged parotid glands can change the shape of a person’s face, which can cause further dissatisfaction with their appearance and compound the body dysmorphia an individual may already be experiencing with bulimia nervosa. Parotid gland swelling and other issues can cause puffy cheeks, pain, and more.

What Are the Parotid Glands?

The parotid glands are two salivary glands that are located in the retromandibular fossa, an area of the face in front of the ears.²

The parotid glands are the largest of the salivary glands. They secrete saliva and play an essential role in chewing, swallowing, speaking, and digesting. Facial nerves responsible for the muscles used to make facial expressions also go through the parotid glands.

In addition to the parotid glands, there are also sublingual and submandibular salivary glands. These all work together to provide the mouth with the moisture it needs. 

While it’s often overlooked, saliva is essential for proper digestive functioning and for maintaining good oral health.

What Problems Can Bulimia Cause?

Repeated self-induced vomiting commonly causes a condition called sialadenosis, which simply means swelling of the salivary glands. In other words, the condition causes the glands to enlarge, leading to significant cheek puffiness.³

While it’s not inflammatory and is simply a result of the salivary glands working hard to increase saliva production, this condition has the potential to significantly alter the way a person’s face looks. This side-effect can be especially distressing for someone who has bulimia, as they likely already struggle with low self-esteem and poor body image.

However, if swollen enough, the salivary ducts of the parotids can become obstructed, which can lead to infection and cause several other symptoms beyond swelling.⁴

Painful lumps may develop, and the salivary ducts may produce foul-tasting discharge. People may also experience difficulty talking, eating, swallowing, or opening their mouths. Some people may also develop a fever and chills or feel fatigued.

Can Parotid Gland Problems Be Permanent?

While parotid gland complications are likely to persist as long as someone continues purging regularly, they’re generally not a permanent condition.

The swelling may continue for some days after an episode of self-induced vomiting. But if the action is not repeated, the parotids are likely to eventually return to their normal size and function on their own. The parotid salivary secretory pattern should also return to normal.

A combination of good oral hygiene, hydration, and medication can also help alleviate some symptoms associated with swollen parotid glands. In some cases, a person may need surgery to fully correct the problems they have developed, especially if their swelling is severe. 

But the best way to reduce “bulimia cheeks” and other signs and symptoms of bulimia is to seek treatment and cease purging behaviors.

Extreme Cases

In some cases, continued purging disorder can lead to permanent facial changes due to the swelling of the parotid glands. Some patients may wish to undergo neck surgery to correct the changes. In some cases, conservative measures are not sufficient, with a parotidectomy being the best option.⁵

A parotidectomy differs from regular maxillofacial surgery (both relate to the head, neck, and face) because it specifically removes the parotid glands.⁶

When to Seek Treatment

Eating disorders such as bulimia are complex mental health illnesses that can have severe, sometimes fatal medical complications. However, full recovery is possible. If you or a loved one is struggling with bulimia nervosa, it’s important to seek treatment immediately. 

Bulimia patients can make a full recovery with the right treatment team behind them.