The human body has three pairs of major salivary glands:
- Parotid glands
- Submandibular glands
- Sublingual glands
Swelling of these glands, but the parotids in particular, is a symptom of both bulimia and anorexia. Often, it’s one of the first visible signs that someone has developed an eating disorder.
Swollen parotid glands generally shrink back down after regular purging or limited food intake has stopped. But sometimes, medical care is required to help.
In the meantime, this condition can cause pain and discomfort. And the swelling can be dramatic, changing the entire shape of the face.
Signs & Symptoms of Enlarged or Swollen Parotid Glands
The largest of the salivary glands, the parotids are the most prone to swelling in people who struggle with eating disorders. They sit along the jawline, on the side of the face, directly in front of the ears.
The parotid glands help you chew, swallow, and digest food by adding saliva, and all its lubricating effects, to the process. When swollen, the enlarged glands can obstruct the natural flow of saliva into the mouth, causing the liquid to get trapped inside. This can be incredibly painful.
If the parotid glands are swollen for a prolonged period of time, they can even become infected. This can cause a number of additional issues, such as:
- Painful and tender lumps in the cheeks
- Putrid-tasting discharge from the gland into the mouth
- Facial swelling
- Difficulty chewing, swallowing, speaking
- Problems opening the mouth fully
What Causes Swelling of the Parotid Gland?
Your parotid glands are sensitive to stress, and the physical demands of disordered eating behavior can cause them to swell.
Self-induced vomiting is one of the biggest causes of this symptom. About half of all people who purge in this way develop parotid gland swelling, though symptoms don’t typically arise until several days after purging has stopped. 
When the body is preparing to vomit, it creates an excess of saliva. In these cases, the fluid is used to coat sensitive tissues, protecting them from the stomach acids brought back up through the digestive tract.
But when someone struggles with purging behavior, they go through this process frequently. This leads to the overstimulation of the parotid glands, which are tasked with producing an increasing amount of saliva. To keep up with the work, the glands will grow in size, in a process called parotid hypertrophy. 
Restrictive Food Intake
Aside from purging, restrictive food intake can also cause salivary gland swelling.
As the body adjusts to receiving less food, it can start producing less saliva in response.  But a change in this eating behavior can cause the glands to overcompensate, resulting in swelling.
Will Inflammation of the Salivary Gland Go Away Without Treatment?
While swollen salivary glands may be painful or uncomfortable, it’s possible to reduce this reaction without seeking further medical treatment.
Sometimes, following a healthy eating program and using a few at-home tips can help ease these symptoms. Some suggestions for helping alleviate parotid gland swelling include: 
- Hard candies: Sucking on a tart sweet can help squeeze the gland and reduce swelling.
- Heat: A heating pad can ease discomfort and encourage fluids to flow out of the gland.
- Anti-inflammatory drugs: Over-the-counter medications can soothe swelling and ease discomfort.
Still, these tips mostly address the symptoms of a bigger problem. If you or a loved one are struggling with an eating disorder, you may experience swollen parotid glands until unhelpful eating behaviors are addressed.
How Is an Inflamed Salivary Gland Treated?
Most of the time, the salivary glands will return to normal once the limited food intake or purging has stopped. But sometimes, swollen salivary glands can develop into a more serious problem, requiring professional attention.
In cases of chronic swelling, you may be able to receive a treatment called sialendoscopy. This minimally-invasive procedure allows doctors to take a closer look at inflamed salivary ducts, and treat them directly.
One small study found the technique to be particularly helpful, with sialendoscopy used to analyze and deliver treatment to the salivary ducts in 6 patients, all of whom struggled with eating disorders. And the procedure led to the alleviation of pain and reduction of gland size in 83% of patients—a considered success, despite the small sample size. 
Finding Help for an Eating Disorder
Swollen saliva glands can be painful, make it difficult to chew or swallow, and may even cause puffiness of the face, sometimes cruelly referred to as “bulimia cheeks,” or “chipmunk cheeks.”
But these uncomfortable symptoms don’t have to last forever.
There are treatments and therapies available that can help you unlearn unhelpful behaviors like self-induced purging. Finding a trustworthy therapist or medical team can not only help you reduce the pain in your cheeks, but address any larger concerns at play.
If you or a loved one are struggling with disordered eating behaviors, it’s never too late to reach out for help. The sooner the condition is treated, the less likely it is that severe health problems will persist.
Treatment works. But seeking it out is the first step toward recovery.
- Allison N, Heather D, Dennis G, Mehler PS. (2021). Medical Complications of Bulimia Nervosa. Cleveland Clinic Journal of Medicine, 88(6):333-343.
- Normal G, Osborne R. (n.d.). The Effect of Bulimia on the Parotid Gland. Osborne Head and Neck Institute. Accessed September 2022.
- Science Shows Early Signs of Eating Disorders Present in the Mouth. (2020, November 13). Today’s RDH. Accessed September 2022.
- Colella, G, Lo Giudice G, De Luca R. et al. (2021). Interventional Sialendoscopy in Parotidomegaly Related to Eating Disorders. Journal of Eating Disorders, 9(25).
The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published January 30, 2023, on EatingDisorderHope.com
Reviewed & Approved on January 30, 2023, by Jacquelyn Ekern MS, LPC