This swelling frequently affects the parotid glands, which are the body’s largest salivary glands, located just under the ears. The issue can cause the cheeks to take on a “chipmunk” appearance, and it can be one of the outward signs of bulimia nervosa.
It’s estimated that anywhere from 10% to 68% of people who struggle with BN develop sialadenosis, or an enlargement of the parotid salivary glands. 
What are the Parotid Glands?
In general, glands are parts of the body responsible for making specific substances. Glands may work to create hormones, tears, milk, sweat, digestive juices, or a number of other fluids.
The parotid glands are responsible for creating saliva. This important substance helps lubricate the mouth during chewing and works to partially digest food, as well as aid in swallowing.
The parotid glands are the biggest saliva producers in the body, but they’re not the only ones. In all, the body has six salivary glands, which work in pairs along the mouth and throat.
And the parotid glands are not the only ones that can be potentially impacted by bulimia nervosa. Some evidence shows that the condition—and, particularly, the self-induced vomiting behavior that often accompanies it—can affect a pair of smaller salivary glands, called the palatal minor salivary glands, causing them to swell. 
How Does Bulimia Impact the Parotid Salivary Glands?
There can be a number of connections between bulimia nervosa and the swelling of the parotid salivary glands. One of the biggest factors is likely the way self-induced vomiting can cause these glands to become overactive.
Self-induced vomiting can cause parotid salivary glands to become overactive and swell.
The parotid salivary glands are designed to produce saliva to lubricate the mouth and throat for various reasons, including protecting the throat from corrosive stomach acid when vomiting occurs. When self-induced vomiting is happening on a regular basis, this can overtax the parotid glands, potentially causing them to swell in response.
The parotid glands also receive signals from both the parasympathetic and sympathetic nervous systems. This means they are affected by both “fight or flight” and “rest and digest” responses.
When either of these functions is dysregulated, which can happen as a result of binging and purging cycles, hypertrophy of the parotid glands can occur, which means that they increase in size or swell to account for increased saliva production.
Long-Term Gland Health Concerns Caused by Bulimia
It is important to understand that sialadenosis, or swelling of the parotid glands, is not the same thing as parotitis, which is inflammation of the parotid glands. Bulimia does not cause the glands to become inflamed, even though they appear swollen.
Instead, the behaviors associated with BN cause these glands to become hypertrophic or larger. But this can lead to further issues.
Swollen parotid glands can make talking, chewing, and swallowing difficult or painful. It can further exasperate nutritional concerns and contribute to body dysmorphic tendencies in cases where swollen glands lead to puffy-looking cheeks.
Chronic sialadenitis can also potentially alter the way the salivary glands naturally drain, which can increase the risk of infection. 
Treatment for Swollen Glands Caused by Bulimia
Thankfully, sialadenosis can usually be treated relatively easily. In many cases, the swelling of the glands will naturally subside after self-induced vomiting stops.
Hydration, warm compresses, massage, and some over-the-counter pain relievers may help someone manage the discomfort of the condition, as well as help encourage swelling to go down.
However, in some cases, the condition becomes chronic. When this happens, it may take surgery or other invasive procedures to help correct the issue.
How to Find a Recovery Program for Bulimia
By and large, the best way to help treat swollen glands, particularly swollen parotid glands, is to treat bulimia nervosa itself.
The condition is a serious disorder that can cause many mental and physical health complications. It is important to seek professional help as early as possible to promote a healthy and sustained recovery.
If you or a loved one are experiencing signs of bulimia nervosa, you may want to start the conversation about recovery with a medical doctor or mental health professional. Insurance providers can potentially provide additional information, including local treatment centers which may accept that insurance.
Additional resources for finding a recovery program include the National Eating Disorders Association (NEDA) helpline. The service is available through text, chat, or phone and offers details on programs, resources, and other information on eating disorders, treatment, and recovery.
The key is finding a treatment program tailored to your or your loved one’s needs. This ensures all physical and mental health issues are addressed, providing you with the needed tools to build a long and healthy life in recovery.
- 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.
- Mignogna, M., Fedele, S., Lo Russo, L. (2004, January). Anorexia/Bulimia – Related Sialadenosis of Palatal Minor Salivary Glands. Journal of Oral Pathology and Medicine; 33(7):441-2.
- Gadodia, A., Bhalla, A. S., Sharma, R., Thakar, A., & Parshad, R. (2011). Bilateral parotid swelling: a radiological review. Dento maxillo facial radiology; 40(7): 403–414.