Eating disorder resources for families & friends

‍Bulimia nervosa can ravage the human body, and we often search for visible signs if we sense a loved one may be struggling. We look for weight changes, listen for negative body talk, and seek out physical signs to confirm our suspicions.

"Chipmunk cheeks" can be a visible sign of bulimia.

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What is sialadenosis or bulimia cheeks?

Sialadenosis, sometimes referred to as “chipmunk cheeks,” can be a noticeable symptom of repeated bulimia behaviors of purging through vomiting. It happens when the salivary glands become irritated and swollen from the repeated exposure to stomach acid. The puffy appearance of the cheeks where the parotid glands are located is sometimes compared to those of a chipmunk with cheek pouches full of food.

Are bulimia cheeks always a sign of bulimia nervosa?

Sialadenosis are not always a sign of an eating disorder. Swollen glands can be the result of a quick onset of an infection. A trip to a healthcare provider can likely resolve this short-term issue due to an infection. Longer term issues, such as autoimmune disease, medication side effects, or poor oral hygiene may also be the root cause of swollen cheeks.

The key to interpreting sialadenosis or bulimia cheeks as a warning sign of bulimia nervosa is to consider the bigger picture. Are there other warning signs that may indicate the possibility of an eating disorder such as bulimia? You may want to consider if the swelling has been going on for some time and what other behaviors or physical signs may be present. Being aware of changes in appearance, behavior, and attitude can help to provide context in determining the cause of swollen cheeks.

How to treat bulimia cheeks

If the puffy appearance of bulimia cheeks is a result of purging behavior, then the way to treat sialadenosis is to seek treatment for bulimia.

The key to helping someone you suspect is struggling with any eating disorder is to take a thoughtful approach to expressing concern. First, remember that all eating disorders, including bulimia, are progressive, so the sooner a person receives treatment for bulimia, the better their prognosis.

Second, consider your place in this person’s life. Are you close enough that you share personal things with one another? Do they value your opinion? If so, then your concerns may be well received if you stick to speaking about what you are observing and how you feel about what you are observing. If you are the person’s parent or guardian, you have the additional ability to arrange for a formal evaluation. If you are an acquaintance, your observations might broaden the overall picture that there is help available.

We’re here to help

If you or your loved one appears to have swollen cheeks, it may be worth addressing whether it’s related to bulimia.

We know finding care can be tough. At Monte Nido, we're here for you. If you are concerned that you, or a loved one, may have bulimia nervosa, please reach out.

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Bullying is not a new topic. It continues to prevelant throughout schools, homes, communities, and online platforms across the United States. About 19.2% of students ages 12-18 enrolled in grades 6-12 experienced bullying nationwide during the 2021-2022 school year. While many believe bullying to be a school-yard problem, one can experience it from peers, coaches, and even family members.

The impact can be profound; victims of bullying face depression, low self-esteem, anxiety, PTSD symptoms and suicide, along with increased feelings of shame, guilt, fear and sadness – many of the same symptoms experienced by those struggling with eating disorders.

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Bullying as a Contributor to Eating Disorders

But can bullying cause an eating disorder? The short answer: Not solely, but it can be a strong contributor factor.

Many factors can lead to an eating disorder like anorexia, bulimia, or binge-eating disorder. While it’s never the same between two individuals, most cases consist of what we often refer to as a ‘perfect storm’ of vulnerabilities, as part of the biopsychosocial model of eating disorder development. 

Factors Influencing the Development of Eating Disorders

Biological Eating Disorder Influences

Family history of eating disorders or other psychiatric disorders, certain brain chemistry, low birth weight and being a twin.

Psychological Eating Disorder Influences 

A person’s thoughts, emotions and behaviors, including low self-esteem, anxiety, depression and stress; difficulty regulating emotions; cognitive distortions in regards to reality and self.

Social Eating Disorder Influences

Cultural, societal and media pressures to maintain an “ideal” body type, weight or physical appearance, with any shortcomings often resulting in dissatisfaction with oneself or hurtful “body shaming” from others.

How Social Media and Bullying Amplify Eating Disorder Risk

It’s the social aspect of the biopsychosocial model where the intersection of bullying and eating disorders come into play, particularly with social media. More than 80 million photos are shared on Instagram daily, 500,0000 “Likes” on Facebook every minute, 500 million Tweets per day and 9,000 photos (“Snaps”) on Snapchat every second. Although much of this content may support positive body image, some promote the opposite – body shaming – with the spreading of harmful rumors and cyber bullying of children and adolescents.

The relation of body image to bullying is strong. In a study of 600 individuals, 90 percent indicated that they are currently bullied and 75 percent reported struggling with a clinically significant eating disorder.

Bullying Fuels Emotional Distress That Can Trigger Eating Disorders

So, how exactly can bullying play into the development of an eating disorder? We know for sure that bullying can increase anxiety and depression, encourage withdrawal and apathy and contribute to feelings of guilt, shame and low self-esteem. 

What do people experiencing uncomfortable emotions want? Relief. Unfortunately, many individuals find it difficult to use the adaptive coping skills when feeling anxious or sad or guilty, and may begin using eating disorder behaviors as coping mechanisms for these intense feelings.

The onset of eating disorders are especially prevalent in children and adolescents who have been bullied for their physical size or shape. This may reflect in an increase of cognitive distortions often with the fear of gaining weight, becoming “fat” or not obtaining the perfect shape and size.

3 Ways to Help Someone Being Bullied

1. Pay attention

‍Whether it’s ourselves or others saying negative things, spreading rumors and/or body shaming, it is important to identify what is going on. Take note if someone is isolating themselves, decreasing time with friends or family or displaying unusual eating habits (reducing food intake, hiding food or eating in secret).

2. Don’t ignore it

‍The phrase “sticks and stones may break my bones, but words can never hurt me” isn’t necessarily true. Words can be very damaging. The more education there is in the community, the more positive self-talk can be created. Starting and maintaining a dialogue can prevent bullying and reduce the number of cases that ultimately lead to an eating disorder.

3. Identify supports

‍There is a wealth of professionals and organizations that are able to help. This includes school counselors, therapists, psychologists and treatment programs to support with symptoms of being bullied and eating disorders. National organizations such as stopbullying.gov and nationaleatingdisorders.org are great too.

Help for Eating Disorders Is Within Reach

There is nothing positive or productive about bullying, especially given the harmful consequences.

We know finding eating disorder treatment can be tough. Monte Nido is here for you. If you are concerned that you, or a loved one, may have an eating disorder, please reach out.

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September is National Suicide Prevention Awareness Month, a time to shine a light on one of the most pressing issues in mental health: suicide. While conversations often focus broadly on depression or trauma, it is essential to recognize the deep connection between eating disorders and suicide risk. Studies show that individuals with eating disorders experience some of the highest rates of suicide among all psychiatric illnesses. For example, suicide is one of the leading causes of death for those with anorexia nervosa, bulimia nervosa, and binge eating disorder.

This heightened risk is tied to the immense emotional pain eating disorders bring, including feelings of hopelessness, shame, isolation, and self-hatred that can overwhelm anyone. Talking openly about suicide can reduce rather than increase suicidal thoughts, making education and awareness critical tools for prevention.

This blog post provides a curated list of suicide prevention resources specifically relevant to eating disorders. Whether you are an individual struggling, a loved one seeking to support someone, or a clinician looking for tools, these resources are designed to open pathways toward hope, safety, and healing.

Understanding the Elevated Risk of Eating Disorders and Suicide

• Suicide rates in anorexia, bulimia, and other eating disorders.

• Contributing factors: depression, PTSD, impulsivity, trauma.

• Why this intersection demands awareness.

Eating disorders are among the deadliest mental health conditions, with suicide being the second leading cause of death.  

Research indicates that individuals with anorexia nervosa are up to 18 times more likely to die by suicide than the general population. Those with bulimia nervosa and binge eating disorder also face elevated suicide rates compared to peers without eating disorders. LGBTQ youth with a diagnosed eating disorder are nearly four times more likely to have attempted suicide in the past year compared to peers who have never had, or only suspected they had, an eating disorder.

Several factors contribute to this intersection. Many clients live with co-occurring depression, PTSD, anxiety, or trauma histories that compound their risk. Traits such as perfectionism, impulsivity, and intense emotional pain also increase vulnerability. People experiencing eating disorders often feel overwhelming guilt, shame, and hopelessness, which can create a dangerous cycle of self-criticism and despair.

The urgency becomes even clearer when looking at global data: suicide is the #1 cause of death among adolescent girls, and the #2 cause of death for individuals aged 10–34. Within eating disorder populations, risk factors such as weight suppression, social isolation, and medical complications add further strain.

Because eating disorders and suicide share such a dangerous overlap, raising awareness is not optional - it’s lifesaving. Families, clinicians, and communities must be equipped to recognize warning signs, understand contributing factors, and offer timely interventions that combine eating disorder care with suicide prevention strategies.

Why Support for Eating Disorders & Mental Health Is Crucial

Stigma and shame remain major barriers for those living with eating disorders and suicidal thoughts. Many feel silenced by fear of being judged or dismissed, making it less likely they will reach out for help. Without compassionate intervention, isolation can reinforce the dangerous belief that no one cares.

Early support changes outcomes. Asking directly about suicidal thoughts does not increase the risk. In fact, research shows it can reduce suicidal ideation by breaking through secrecy and showing that someone is willing to listen. Communities, caregivers, and professionals who create safe, nonjudgmental spaces play a crucial role in reducing risk and encouraging treatment engagement.

Eating disorder recovery requires not only nutritional rehabilitation but also attention to the emotional struggles that accompany the illness. By combining evidence-based therapies with suicide prevention strategies, treatment can address the whole person—body, mind, and spirit. Supporting those at risk is about more than safety; it is about affirming their worth and helping them envision a future beyond the eating disorder.

Curated Directory of Resources for Eating Disorders & Suicide Risk

Crisis Hotlines & Immediate Help

• 988 Suicide & Crisis Lifeline (U.S.): Call or text 988 for 24/7 confidential support from trained crisis counselors.

• Crisis Text Line: Text HELLO to 741741 to connect with a crisis counselor.

Warning signs of acute suicide risk include talking about wanting to die, seeking access to lethal means, or showing dramatic mood changes. If these behaviors appear, immediate help is necessary. Parents, friends, and caregivers should never wait to act - call 911 if someone is in imminent danger.

Eating Disorder–Specific Support

• Monte Nido: Offers inpatient, residential, PHP, IOP, and virtual treatment, with suicide prevention integrated into care.

Eating disorder–specific hotlines and organizations provide targeted support for those whose struggles with food and body are closely tied to suicidal thoughts.

Broader Mental Health & Suicide Prevention Organizations

• American Foundation for Suicide Prevention (AFSP): Offers research, advocacy, and support groups.

• The Trevor Project: Crisis services for LGBTQ+ youth, who face elevated risk for both eating disorders and suicide.

These organizations provide a wider net of mental health resources that complement eating disorder–specific supports.

Safety Planning & Emergency Tools

If an individual is struggling with suicidal thinking, a mental health professional can help develop a Safety Plan which can be designed to give individuals a step-by-step approach for managing suicidal thoughts when they arise.  These plans can offer a crucial bridge between a crisis and ongoing treatment.

Professional & Educational Resources

Mental health professionals are trained to provide a suicide risk assessment and when needed to help someone into the level of care that can best assist them.  Additionally, there are numerous continuing education programs designed to equip professionals with the latest knowledge and to ensure that suicide prevention is embedded in treatment programs, schools, and healthcare systems.

How to Use These Resources

• For individuals: keeping numbers accessible, joining groups, therapy.

• For loved ones: listening, validating, helping with safety plans.
  For clinicians/educators: screening, integrating safety planning, awareness in programs.

Suicide prevention resources are most effective when they are accessible and actively used. Individuals living with eating disorders can benefit from keeping hotline numbers saved in their phone, downloading safety planning apps, and exploring peer support communities. Therapy and structured treatment programs remain essential in reducing long-term risk.

For loved ones, the role is to listen without judgment, validate feelings, and encourage the use of crisis services when needed. Parents and caregivers can help teens create safety plans, remind them of available resources, and normalize asking for help. Even if conversations feel unproductive, research shows that those at risk are often listening closely.

For clinicians and educators, resources should be integrated into daily practice. Screening for suicide risk, creating safety plans, and connecting students or clients with crisis services are essential steps. Educational institutions and treatment centers alike can reduce stigma by openly discussing suicide prevention and ensuring that staff are trained in compassionate intervention.

The key is to make these tools part of everyday life—visible, accessible, and actively used, so that when risk arises, help feels within reach.

Taking Action: Support for Suicide and Eating Disorders

Suicide prevention starts with awareness and action. Saving helpline numbers, sharing them with others, and talking openly about eating disorders and suicide can create life-saving connections. Each conversation helps break stigma and reminds those struggling that they are not alone.

Monte Nido offers evidence-based, compassionate treatment designed to address both eating disorders and the co-occurring risks that come with them. If you or someone you know is in need, reach out today. Every step toward connection is a step away from isolation, and toward recovery.

Hope and Healing Beyond Suicide and Eating Disorders

Eating disorders carry a high risk of suicide, but risk does not define destiny. With timely support, compassionate treatment, and strong community connections, healing is possible. Talking openly about suicide does not create risk - it creates relief, reminding individuals that their pain can be shared and lightened.

No one has to face this alone. Help is always available, and recovery is within reach. By raising awareness this Suicide Prevention Month and beyond, we can help more people move from despair to hope—and toward lives full of meaning and possibility.