Purging in bulimia by vomiting can make the face and cheeks appear swollen or puffy due to effects on the salivary glands. The glands typically return to their usual size after habitual vomiting stops.

Bulimia nervosa is a mental health condition characterized by episodes of binge eating followed by compensatory measures, such as self-induced vomiting.

Habitual vomiting in bulimia can cause the face to appear swollen. Some people may refer to this as “bulimia face” or “bulimia cheeks.” It happens when vomiting causes swelling in the salivary glands known as the parotid glands or, more rarely, in the submandibular salivary gland.

Swelling in the parotid glands is known as sialadenosis, and swelling in the submandibular salivary gland is known as submandibular sialadenitis.

This swelling isn’t permanent, but it usually doesn’t go away until habitual vomiting stops.

Keep reading to learn about the symptoms of swollen parotid glands, why they occur, and how to treat them.

Help is available

If you’re preoccupied with food or your weight, feel guilt about food choices, or engage in restrictive diets, consider reaching out for support. These behaviors may indicate a disordered relationship with food or an eating disorder.

Disordered eating and eating disorders can affect anyone, regardless of gender identity, race, age, socioeconomic status, or other identities. They can be caused by any combination of biological, social, cultural, and environmental factors, not just by exposure to diet culture.

Consider speaking with a healthcare professional or contacting the National Alliance for Eating Disorders, which offers a daytime helpline staffed by licensed therapists and an online search tool for treatment options.

For general mental health support at any time, you can call the Substance Abuse and Mental Health Services Administration 24 hours a day at 1-800-662-4357 (or 1-800-487-4889 for TTY).

Swelling in your salivary glands can make your face appear swollen or puffy. It may also cause other symptoms, such as:

  • mild discomfort
  • tenderness around the swollen glands
  • symptoms of infection, such as pain or warmth around the swollen glands

Swelling in the salivary glands due to bulimia can become more severe over time without treatment and if habitual vomiting continues.

If you have concerning symptoms, including severe pain or symptoms of an infection, it’s best to seek urgent care from a doctor.

Your salivary glands are usually small. They’re located in the inner linings of your mouth, lips, and cheeks.

But habitual vomiting can irritate the salivary glands and cause them to swell and become larger.

Your salivary glands produce saliva, which has multiple purposes that include:

  • keeping your mouth moist
  • protecting your teeth from decay
  • helping digest your food

The salivary glands also produce saliva to prepare the body for vomiting. Excess saliva production helps protect the mouth from the acidity of vomit.

If you vomit regularly, the salivary glands may increase in size to produce more saliva.

The swelling may affect your appearance and cause discomfort.

Puffy cheeks due to bulimia usually go away with time if habitual vomiting stops.

Swollen salivary glands may initially store more saliva after you’ve stopped having vomiting episodes. But the swelling will likely decrease over time.

The only way to fully resolve swollen salivary glands due to bulimia is to get treatment for bulimia, with the goal of stopping habitual vomiting episodes from occurring. The glands should then return to their typical size.

Certain home remedies may help you manage some of the swelling and discomfort. But these remedies are unlikely to resolve the swelling if vomiting continues.

Home remedies for swollen salivary glands include:

Note that NSAIDs can have side effects, especially if you take them often or on an empty stomach, or if you exceed the daily dose. In people with eating disorders, they may cause gastrointestinal issues, so it is best to talk with a doctor before taking them.

If the swollen glands don’t recede and you’re in or have completed treatment for bulimia, doctors may be able to prescribe medication to help your glands return to their previous size.

Bulimia is a complex mental health condition. Treating it often requires a combination of specialists and approaches, which can include:

  • Medical treatment for complications: A doctor may provide medical treatment for complications of bulimia, including electrolyte imbalances and salivary gland swelling.
  • Dental treatment for complications: Some people who have engaged in habitual vomiting for an extended period may require specialized care from a dental practitioner to manage damage to the teeth, such as erosion.
  • Therapy for mental health support: Tailored therapy for eating disorders from a licensed therapist can help you unpack thoughts and behaviors that may contribute to bulimia. A therapist can teach you strategies that help with managing things like stress responses, negative self-talk, and social factors. They may also help you rebuild your relationship with food.
  • Dietitian support: Working with a licensed dietitian can help you plan nutritious meals and adjust your eating habits.

Bulimia with self-induced vomiting can cause the salivary glands to swell and become enlarged. This can cause the facial swelling that some people refer to as “bulimia face” or “bulimia cheeks.”

While the only way to return the salivary glands to their former size is to treat bulimia so that habitual vomiting no longer occurs, you may be able to relieve some discomfort by applying a heating pad.