Bulimia nervosa is a type of eating disorder characterized by recurrent binging and purging, a destructive cycle that often leaves bulimic individuals completely depleted of essential vitamins and minerals. In addition to causing serious internal problems, long-term bulimia nervosa can also lead to the development of a wide range of externally apparent physical symptoms. One of these side-effects is bulimia cheeks, also known as chipmunk cheeks.

What are Chipmunk Cheeks?

Two of the most common methods of purging employed by bulimic individuals are self-induced vomiting and laxative abuse. When a person chooses to induce vomiting, the parotid glands, the pair of which are located in the back of your mouth, will produce extra saliva in order to protect the esophagus and the mouth from stomach acid. As people with bulimia nervosa tend to self-induce vomiting multiple times a day, the parotid gland will typically become swollen from overexertion. Consistent vomiting ultimately results in swelling of the area between the jawbone and the neck, resulting in puffy, chipmunk-like cheeks.

Parotid hypertrophy, or swelling of the parotid glands, can be a distressing and disheartening symptom for individuals suffering from bulimia, as they can often misinterpret the swelling as further evidence of weight gain or unattractiveness.

Are Chipmunk Cheeks Dangerous?

Parotid hypertrophy is not, in itself, dangerous and will usually disappear once the vomiting has ceased and the individual in question has returned to a regular diet. However, it is important that the underlying cause of parotid hypertrophy is addressed, otherwise, the issue will only worsen with time. In fact, if an individual continues to put an abnormal strain on their parotid glands, the glands may never return to their normal size.

If the parotid glands never return to their normal size following the cessation of purging, there are surgical procedures that can help reduce the size of the parotid glands and reduce the swelling of the face. One of these procedures, known as a superficial parotidectomy, involves removing the superficial lobe of the parotid gland, resulting in significantly less bulge in the cheek area. Although this procedure is effective, it usually results in scarring around the neck and can, in extreme cases, cause facial paralysis.

Due to the often guarded nature of bulimics, identifying whether an individual is suffering from bulimia nervosa can be a challenging task. In some cases, the presence of chipmunk cheeks can be an indicator of a purging-related illness. However, you should always consult with a medical professional before asking someone if they are struggling with an eating disorder.

Sources: National Eating Disorders Association, Osborne Head & Neck Institute, Eating Disorders Glossary

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