What physical examination findings might be present in a patient with bulimia nervosa?

In a patient with bulimia nervosa, the presence of teeth pitting and parotid gland hypertrophy is a key physical examination finding. The repeated cycles of binge eating followed by purging behaviors, such as vomiting, can lead to dental erosion due to stomach acid. This erosion manifests as enamel loss and pitting on the teeth. Additionally, the act of vomiting can cause hypertrophy of the parotid glands, which may become enlarged due to the increased demand for saliva production to help neutralize the acidity brought on by repeated exposure to gastric acid.

Other potential signs of bulimia can include electrolyte imbalances and other systemic effects from purging, but the specific findings of dental changes and gland enlargement are particularly characteristic of the disorder. These physical signs help clinicians identify the disorder and provide the necessary interventions to support the patient.