“Bulimia cheeks” refers to the noticeable puffiness or swelling that develops on the sides of the face. This swelling is a direct consequence of frequent, self-induced vomiting, a purging behavior associated with Bulimia Nervosa. Medically, this condition is known as sialadenosis, the non-inflammatory enlargement of the salivary glands. Specifically, it involves the parotid glands, which are the largest salivary glands located just in front of the ears.
Understanding Parotid Gland Swelling
The physiological mechanism behind the facial swelling involves the body’s protective response to repeated exposure to stomach acid. When a person purges through vomiting, the salivary glands are stimulated to produce a large volume of saliva to neutralize the acid and protect the lining of the mouth and esophagus. This repeated, chronic activation leads to the condition known as sialadenosis, which is typically a benign, bilateral swelling.
The frequent overstimulation causes the acinar cells within the parotid glands, which are responsible for producing and secreting saliva, to hypertrophy, meaning they physically enlarge. This cellular growth increases the overall volume of the gland, resulting in the characteristic puffy appearance. This type of swelling is primarily a non-inflammatory response, a form of work-related enlargement rather than an infection. Nutritional factors, such as changes in fluid and electrolytes that accompany the cycle of bingeing and purging, may also contribute to the overall enlargement of the glands.
How Long Does it Take to Resolve?
The resolution of parotid gland swelling is dependent on the sustained cessation of the purging behavior. As long as self-induced vomiting continues, the salivary glands will remain chronically overstimulated, and the swelling will not subside. The process of the glands shrinking back to their normal size begins once the destructive cycle is broken.
For many individuals, the swelling begins to diminish within a few weeks after stopping the purging. While significant reduction may occur within two to four weeks, it can take up to several months for the glands to fully return to their baseline size. Factors that influence the duration include the individual’s nutritional status, the frequency and duration of the purging behaviors, and the severity of the initial enlargement.
In some cases, the swelling may acutely worsen or appear a few days after purging stops before it begins to improve. This temporary increase in puffiness is a known occurrence during the initial stages of recovery. Consistent abstinence from purging is the only reliable path to seeing the physical symptoms of sialadenosis resolve over time.
Supportive Care and Medical Intervention
Once recovery has started, certain supportive measures can help manage the discomfort and encourage the swelling to subside naturally. Maintaining consistent hydration is beneficial, as is practicing good oral hygiene to prevent secondary issues. Applying warm compresses to the swollen area may help reduce discomfort and promote circulation in the glands.
Over-the-counter anti-inflammatory medications can be used to alleviate pain and swelling. Additionally, medical professionals might recommend sucking on tart candies or lozenges to encourage increased salivary flow, which can help flush the ducts and reduce the size of the gland.
In rare and persistent cases where the swelling is refractory, a medical professional may consider prescription interventions. This might involve medications like pilocarpine, a drug that can help reduce the size of the enlarged glands. Surgical intervention, such as a parotidectomy, is considered only in severe, long-standing cases where conservative measures have failed, and the patient has maintained abstinence from purging for a prolonged period.