Bulimia nervosa is a serious eating disorder defined by recurrent episodes of binge eating followed by compensatory behaviors, such as self-induced vomiting, misuse of laxatives, or excessive exercise. These purging behaviors, especially repeated vomiting, can lead to a range of physical side effects. One notable physical symptom is the enlargement of the salivary glands, which causes a distinct facial swelling commonly referred to as “Bulimia Face” or “chipmunk cheeks.” The swelling can be a source of distress, but it is a sign of the underlying medical issue that requires professional attention.
The Appearance of Bulimia Face
“Bulimia Face” is the puffiness that develops around the jawline and cheeks. The swelling typically presents symmetrically on both sides of the face, extending from just in front of the ears down to the angle of the jaw. This bilateral enlargement creates a rounded, fuller appearance to the lower face. While the term suggests the cheeks themselves are swollen, the change in appearance is actually due to the enlargement of a pair of major salivary glands, which is usually not painful but can be aesthetically troubling for the individual.
The Physiological Cause of Facial Swelling
The underlying cause of this facial swelling is the hypertrophy, or enlargement, of the parotid glands, which are the largest salivary glands. Repeated self-induced vomiting causes chronic stimulation of these glands. When the body anticipates or engages in vomiting, the salivary glands increase saliva production to help protect the mouth and esophagus from the corrosive stomach acid. This constant over-activation acts as a form of “work hypertrophy,” causing the glandular tissue to grow in size to compensate for the demand. The medical term for this non-inflammatory, non-cancerous enlargement is sialadenosis, which involves repeated cholinergic stimulation of the gland, leading to an increase in the size of the acinar cells. In some cases, this glandular enlargement can be further compounded by the fluid retention and electrolyte imbalances that often accompany bulimia nervosa.
Resolution and Recovery
The facial swelling associated with bulimia is often reversible, but resolution is directly dependent on stopping the purging behavior, as the parotid glands will not shrink until the cycle of chronic stimulation is broken. This cessation of self-induced vomiting is the single most important step for recovery of the facial contour. The swelling may initially become more noticeable for a few days immediately after purging stops, which can be discouraging for the person recovering. With consistent abstinence from purging, the glands typically begin to subside over time, with the timeline for complete resolution ranging from a few weeks to several months. Medical professionals may sometimes use supportive measures to manage discomfort, such as applying warm compresses or ensuring proper hydration, but the most effective and sustainable treatment is the comprehensive treatment of the underlying eating disorder itself.