Q. I have a bulimic, pregnant friend. What can happen to her and the baby?

A. Bulimia is a psychological condition, when a person eats too much. It is often associated with vomiting. Bulimia is a dangerous condition for the pregnant patient for a variety of reasons. For the baby, the primary effect depends whether or not there is vomiting. Eating a lot causes the woman to gain weight. This increases her chances for medical problems and an overweight baby. The pregnant patient may have a difficult delivery, as well as a prolonged labor with a C-section birth. It may cause the baby chemical problems with blood glucose on the first two days of life. In the end, most babies do fine, but the complications must be dealt with. If there is vomiting, weight gain is unlikely, and problems associating with maternal weight gain don't occur. When bulimic patients don't gain enough weight in pregnancy, weight loss becomes serious for the baby. Remember that your bulimic friend is eating for two, and if she is vomiting to lose weight, then the baby may not be receiving enough nutrition to develop normally. Some suggested reading on bulimia and anorexia nervosa can be found at http://members.tripod.co.uk/rb/rb178.htm.

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