Bulimia and Parotid Swelling

Bulimia, or “ox hunger,” is characterized by episodes of binge eating, during which there is a large intake of food over a short time span, followed by induced vomiting and occasionally periods of fasting. Classically, the problem starts in a teenage female who perceives herself as being too fat. As a result, the person develops feelings of guilt and low self-esteem.‘,’ An attempt at dieting leads to some weight loss and simultaneous hunger. In the susceptible individual, this hunger results in an eating binge. To counter the effect of the weight gain from the eating binge, self-induced vomiting is initiated. Once the individual realizes that the weight gain caused by the binge can be nullified by vomiting, less restraint is exerted on the binges. A natural progression is for the person to resort to binges not only when hungry, but also when tense or anxious.3 Vomiting is usually carried out in secret, and often with the aid of the emetic ipecac. Laxatives and diuretics frequently become adjunctive agents. Although bulimics may binge and vomit as little as twice a week, the frequency varies and it can become as high as 140 episodes each week.3-6 The average intake of food is 3,400 calories in a 1.2-hour period, with some patients ingesting as much as 50,000 calories in a 24