Jun 20th 2023
Bulimia nervosa is an eating disorder, that is often characterized by repeated episodes of binge eating followed by purging behaviors, such as self-induced vomiting. These behaviors and their consequences can cause several effects on a person’s physical health. One physical consequence includes swollen salivary glands, occasionally known as ‘bulimia face’.
Eating disorders are mental health conditions that impact the way an individual feels and behaves in relation to food and body image. Bulimia nervosa is a type of eating disorder that often involves purging behaviors, such as self-induced vomiting, excessive exercising, or abusing laxatives or diuretics .
Regularly engaging in self-induced vomiting can cause many physical symptoms. Some of the physical symptoms can be treated and some can become severe or even fatal. One physical effect of self-induced vomiting is sialadenosis, or the swelling of salivary glands .
This usually affects the parotid glands. The parotid glands swell up and cause puffy-looking cheeks that can feel tender, although typically do not cause a lot of pain. The appearance of sialadenosis is sometimes known as ‘chipmunk cheeks’ or ‘bulimia face’. It is a condition that affects up to two thirds of those with bulimia, depending on the frequency and duration of self-induced vomiting .
The exact cause of sialadenosis is not clear but it often begins in the days following the stopping of vomiting. Due to this, it is thought that it may be caused by excess saliva being produced during vomiting, which then causes the glands to grow in size to accommodate for the extra saliva .
The salivary glands are located around the jaw area, with the parotid glands located in front of the ears. When they become swollen, this can cause the appearance of very puffy or large cheeks, hence the use of the term ‘chipmunk cheeks’. This effect can worsen if purging continues .
Those with bulimia commonly experience concerns and issues related to appearance and body image. The emergence of swollen glands and cheeks can worsen these concerns, potentially causing an increase in purging behaviors in an attempt to lose weight. This creates a problematic cycle thus worsening the effect on the salivary glands.
Typically, individuals with bulimia will hide their disordered eating behaviors and may struggle to discuss their condition or ask for help. In many instances, warning signs of the condition will first be noticed by a medical professional or family member.
‘Bulimia face’ or ‘chipmunk cheeks’ are a symptom that often develop later in the condition with the cessation of purging or the restarting of previously ceased purging. Therefore, early warning signs typically aren’t shown in the face .
Typically, parotid gland swelling will reduce on its own if purging behaviors remain ceased. As such, many individuals do not require treatment for this physical condition alone and will find that the swelling reduces within several weeks .
However, for some people, this swelling does not reduce on its own so may require some intervention. It may be helpful in this time to consume sour or tart foods to promote saliva flow, which can aid in the reduction of swelling. Another intervention includes the use of anti-inflammatory medications .
In order to treat swollen glands caused by bulimia and prevent recurring symptoms, the condition itself must be treated effectively. The continuation of purging behaviors will worsen or prolong swelling. Treatment for bulimia typically involves a multidisciplinary team of professionals, including physicians, dieticians, and specialized therapists .
The swelling of the salivary glands caused by bulimia is often reversible, typically leaving no long-term physical impact on the individual. The reversal of ‘bulimia face’ is dependent on effective treatment and management of the condition .
However, if bulimia symptoms persist or are untreated, it is possible for the glands to become infected due to blockages or poor hydration, which is known as sialadenitis. This can cause more severe symptoms, including fever, pain, tenderness, increased swelling, and infectious fluid buildup in the glands. This condition requires medical treatment, such as antibiotics and hydration .
Without effective treatment, bulimia can cause many serious physical health problems. Mostly, these complications can be managed and reduced with professional intervention, but others can cause severe long-term health issues, or even death.
If you know someone who struggles with bulimia nervosa, don’t hesitate to support them by encouraging them to seek professional treatment to overcome their disorder.
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