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Answer: The closest gemara on the subject says that pregnant and nursing women are required to fast on Tisha B’av (Pesachim 54b). Rishonim posit that this is because they are considered healthy, but that a woman within thirty days after childbirth and a person who is sick with a not-expected-to-be dangerous illness need not fast (see Ran, Ta’anit 10a of Rif’s pages; Beit Yosef, Orach Chayim 554). Although such people must fast on Yom Kippur (see details in Shulchan Aruch, OC 617:4), Tisha B’av is different because it is not a Torah-level prohibition. Even though the non-dangerously sick may not eat a Rabbinically forbidden food (Shulchan Aruch, Yoreh Deah 123:2), the Rabbis built into the institution of the fast of Tisha B’av that it does not apply to clearly sick/weak people (Ran, ibid.; Shulchan Aruch, OC 554:6).
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Regarding a woman after childbirth, the Rama (OC 554:6) says that despite the halachic exemption, the minhag is to fast (see Chayei Adam II, 135:2; Mishna Berura 554:13). Regarding a sick person, stringency is less encouraged (ibid. and ibid:16).
To what extent do we say the fast does not exist, as opposed to the situation of a dangerously sick person on Yom Kippur, to whom the fast exists but is compromised as needed (Shulchan Aruch, OC 618:7)? The Shulchan Aruch (OC 554:6) says it was not instituted for them – apparently, at all. Therefore, several poskim said that there is no need to limit eating (Kaf Hachayim, OC 554:31; Avnei Nezer, OC 540; Shevet Halevi IV:56).
It is also possible to say that a sick person should try to limit the amount of eating on Tisha B’av, but the specific size/time formula (shiurim) we find regarding Yom Kippur (see Shulchan Aruch, OC 618:8) is irrelevant. The Aruch Hashulchan (OC 554:7) implies that shiurim are significant only concerning Torah-law prohibitions. There, they are important for the Torah punishment, which does not apply to Rabbinic prohibitions like eating on Tisha B’av. This is not obvious because the gemara (Yoma 79a) bases the amounts for Yom Kippur on their effect on the experience of fasting, which can apply to Tisha B’av as well.
The difference between the approaches to why not to require shiurim is regarding other means of limiting the eating. The Chayei Adam (ibid.) says that one should try to fast part of the day (see Yoma 82a in regard to the partial fasting of children under bar/bat mitzva). Some explain that the delaying or minimizing of the eating does not indicate a partial existence of the fast per se, but is based on the idea of wanting to share with the general pain that everyone is experiencing (see Chut Shani III:93). There may be a distinction between someone who starts the day fully sick and someone who we do not want to fast because it likely will make him sick, in which case he should wait until it is necessary (see Dirshu 554:26).
[Most people reading this are more likely to be more stringent on this matter than required, or even more than preferable, than to be too lenient; it is hard to blame them.]
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