The increase of bariatric surgery patients implies that more of them will present to intensive care units with altered gastrointestinal anatomy. Intensive care unit patients who have a history of recent or previous bariatric surgery comprise a unique population for conducting nutritional assessments and developing nutrition care plans. An assumption that such patients can automatically be assigned to guidelines intended for critically ill obese patients is problematic. Limited research exists to define appropriate nutrition support practice in the postbariatric population. This review provides an overview of bariatric surgical procedures with an emphasis on the sequelae of altered gastrointestinal anatomy, the evaluation of current evidence on providing nutrition support to critically ill patients who have a history of bariatric surgery, and to update clinical guidelines for delivering nutrition support to these patients.