When purging-type bulimia nervosa (BN) is expressed through self-induced vomiting, it has the potential to affect the parotid glands. The action can strain these glands, leading to potential health issues.
Unfortunately, these problems can sometimes change the shape of a person’s face, which can cause them to be further dissatisfied with their body, on top of the body dysmorphia already associated with bulimia nervosa.
50% of bulimia patients report puffy cheeks.
Parotid gland issues can cause puffy cheeks, pain, and more. Sometimes referred to as “bulimia cheeks,” swollen parotid glands are one of the more visible signs of a person struggling with bulimia. In fact, as many as 50% of bulimia patients report cheek puffiness caused by parotid gland hypertrophy, according to one study. 
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. 
The parotid glands are the largest of the salivary glands. They secrete saliva, and they play an essential role in:
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 the moisture it needs, although issues with just one gland can still cause significant issues with this system.
What Problems Can Bulimia Cause?
Bulimia nervosa, when expressed through self-induced vomiting, commonly causes a condition called sialadenosis, which is a noninflammatory, non-neoplastic swelling of the salivary glands. In other words, the condition causes the glands to enlarge, leading to significant cheek puffiness. 
When serious enough, this condition can significantly alter how a person’s face looks. This side-effect can be especially distressing for someone experiencing BN, who may already struggle with low self-esteem and poor body image.
If swollen enough, the salivary ducts of the parotids can also become obstructed, which can lead to infection and cause several other symptoms beyond swelling. 
Painful lumps may develop, and foul-tasting discharge may leak out from their salivary ducts. People may also have trouble talking, eating, swallowing, or even opening their mouths. Some people 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 on a regular basis, 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 right combination of good oral hygiene, hydration, and medication can also help ease some of the worse symptoms of swollen parotid glands. And in some cases, a person may need surgery to fully correct the problems they have developed, especially if their swelling is severe.
Still, by and large, the best way to help reduce “bulimia cheeks” is to seek treatment for bulimia nervosa. Helping restore the parotid glands is just one of the many benefits that can come from seeking treatment.
Where to Locate Treatment Centers
If you or a loved one are struggling with bulimia nervosa, it’s important to seek treatment for the condition. Thankfully, the internet has made it much easier for many people to find the help they need.
National Eating Disorders Association
If you’re unsure where to start, the National Eating Disorders Association (NEDA) can be a good resource to look for eating disorder treatment centers. This nonprofit organization has created a tool that allows you to look for in-person treatment providers in your area. 
If you don’t see a treatment provider near you, keep in mind that this tool doesn’t necessarily have all treatment providers on it. And remember: you can also try a virtual option.
Online therapy is especially promising for bulimia nervosa, as the condition is frequently treated with cognitive behavioral therapy, which can often be effectively administered online. This option can be a more viable and convenient option for most.
NEDA also offers a helpline, which you can call at 1-800-931-2237, text at 1-800-931-2237, or chat with online. Through this helpline, you can talk with trained volunteers who can help provide some advice on how to find support and other sources of information you may need to get help for your eating disorder and reduce the harm your condition may be doing to your physical and mental health. 
Bulimia nervosa can significantly affect physical and mental health, but it’s important to remember that full recovery is possible with the right help.
- Buchanan, J., Fortune, F. (1994). Bilateral Parotid Enlargement as a Presenting Feature of Bulimia Nervosa in a Post-Adolescent Male. Postgraduate Medicine Journal. 70: 27-30.
- Chason, H., Downs, B. (2022, June 11). Anatomy, Head and Neck, Parotid Gland. StatPearls.
- Garcia 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.
- Parotid Gland Swelling: Symptoms, Treatment, and Prevention. (2022, September 15). Colgate. Retrieved September 18, 2022.
- Treatment Providers. National Eating Disorders Association. Retrieved September 18, 2022.
- Contact the Helpline. National Eating Disorders Association. Retrieved September 18, 2022.