Tax Season Wake-Up Call for Weight Loss Practitioners

How to Avoid Costly Surprises and Build a Financially Stable Practice 

If tax season leaves you feeling a little anxious, or worse, staring at an unexpected tax bill, you are not alone. 

Every year, I talk with weight loss practitioners who are doing all the right things clinically but getting blindsided financially. And at the time of this writing, tax season has once again surfaced a familiar pattern: volume change, new services, reinvestment, and/or big decisions made without a proactive tax strategy. 

The good news? For most practitioners, this only happens once – especially if you use it as a turning point instead of a recurring stressful event. 

Let’s talk about why unexpected tax bills happen, what to do right now, and how to set your practice up so this doesn’t repeat itself next year. 

Why Weight Loss Practices Can Get Hit with Unexpected Tax Bills 

The past few years have been anything but “business as usual” in the weight loss and obesity medicine space. 

Many practices experienced:

• Rapid growth fueled by GLP-1 medications
• New service lines (aesthetics, IV therapy, body contouring, lifestyle medicine programs)
• Increased marketing spend
• New hires or expanded teams
• Investment in software, EMRs, and patient engagement platforms 

All of these are smart, forward-thinking moves – if they’re planned for properly. 

Where things often go sideways is when:

• Quarterly taxes were underpaid
• Deductions weren’t categorized correctly
• Cash flow felt strong, but profit wasn’t actually tracked
• Revenue grew faster than financial systems could keep up 

So, when your CPA says, “You underpaid your quarterlies,” or “This wasn’t deductible the way you thought,” the financial sting feels very real. 

I’ve been there myself.

And I can tell you with confidence: clarity is the cure for money stress. While I do not claim to be an accountant and recommend you refer to your qualified accountant, below are steps to avoid turmoil when it comes to your practice finances and tax time. 

Step One: Get Crystal Clear on What Actually Happened 

Before you can fix anything, you need visibility. 

I want you to block 30 focused minutes and review:

• Your total revenue for last year
• Your total expenses (by category)
• What was deductible vs. non-deductible
• How much you paid—or didn’t pay—in quarterly taxes
• Where the surprises came from 

If you don’t personally review your numbers monthly, ask your bookkeeper or accountant for a clean snapshot. 

This is why I love reviewing numbers around the 10th of every month. That ensures you are looking at real data on a regular basis to avoid surprises and guesses as to your current status. 

And just as important:

Make sure you’re working with a CPA who understands private medical practices, not someone who only meets with you once a year. Ideally, your CPA is a proactive partner in your success, not a tax-season firefighter. 

Step Two: Deal with the “Now” (Don’t Avoid It) 

If you owe more than expected:

• Ask about IRS payment plans (they exist and are manageable)
• Get clear on the exact amount and timeline
• Address it promptly since waiting only adds stress and penalties 

The IRS is far easier to work with when you’re proactive. Extensions may feel tempting, but for many practice owners, they simply delay the emotional and financial weight. 

Handle the present and then immediately shift your energy forward. 

Step Three: Build a Smarter Financial Rhythm Going Forward (Your Financial System) 

What you do this quarter can dramatically change next year’s tax outcome. 

Here’s what I recommend for today’s proactive weight loss practices: 

1.  Review Your Financials Monthly (Not Just Quarterly) 

Quarterly tax planning is helpful—but monthly awareness is powerful. 

Revenue, expenses, cost of goods sold, staffing, marketing spend, payer mix, and resulting profitability can shift quickly, especially with GLP-1 utilization, cash-pay programs, and bundled offerings. 

Monthly reviews allow you to adjust before problems snowball. 

2.  Track Profit, Not Just Revenue 

This is one of the biggest mindset shifts I see practices struggle with. 

Growing revenue feels exciting, but profit is what determines stability. 

If your practice brings in $1M but spends nearly all of it, that’s not growth—it’s stress in disguise. Thin margins are often the root cause of unexpected tax problems. 

Know:

• Your true operating margin
• Your fixed vs. variable expenses
• Which services actually drive profit 

3.  Separate Business and Personal Finances (Completely) 

Most established practices do this. However, newer ones sometimes blur the lines. 

Make sure:

• Business and personal accounts are fully separate
• Owner draws and payroll are clearly defined
• Spending decisions are intentional, not reactive 

4.  Create a Dedicated Tax Savings Account 

One of the simplest—and most effective—habits is to move 25–30% of profits into a separate tax savings account every month. Out of sight. Out of spending temptation. 

This single step prevents panic, scrambling, and last-minute stress when quarterly or annual taxes are due. 

5.  Use the Right Financial Tools (Consistently) 

Whether it’s:

• QuickBooks
• Wave
• A well-structured spreadsheet
• Or a bookkeeper you trust 

Do not leave your financial tracking to chance, or to tax season. 

And please don’t wait until next year to “catch up.” Delayed bookkeeping is one of the fastest ways to lose control of your numbers. 

Bonus Tip: Get Advice Before Big Decisions 

Before you:

• Buy expensive equipment
• Add a full-time team member
• Launch a new service line
• Expand locations or offerings 

Run the numbers first. 

Your return on investment (ROI) may look good in theory, but timing, cash flow, and business stage matter. A decision that’s right for one practice can be wrong for another. 

Ideally, these conversations happen with:

• Your CPA
• A strategic advisor who understands healthcare operations and growth 

This is where smart planning protects your energy, your cash, and your long-term vision. 

Stability, Growth, and Leadership 

Tax season may not be the most exciting topic, but it’s one of the most powerful ways to protect and grow your practice. 

If last year felt messy, there’s no shame in that. Many excellent practitioners have been there. The key is using the experience as fuel to make more strategic, confident decisions going forward. 

Everything I share—here and on the Bariatric Business Accelerator Podcast comes from real-world experience. These aren’t theories. They’re systems I use and strategies I’ve seen work across practices for over two decades. 

So, keep serving your patients.

Keep scaling with intention.

And keep showing up for the vision you have for your practice. 

If this article helped you, share it with a fellow practitioner—and make sure you’re subscribed to my weekly business building newsletter so you don’t miss what’s next.