Case Study · Medical Weight Loss / Med Spa (multi-location, AZ and TX)
Red Mountain Weight Loss: Rebuilding the Search Foundation for a Multi-State Medical Weight Loss Group
85% SEMrush site health, warnings down 460 (Aug 2020)
Red Mountain Weight Loss, a medical weight loss and med spa group with locations across Arizona and Texas, began 2019 with its search authority split across five separately indexed web properties, 92 percent of its images missing alt text, and zero structured data anywhere on the site. Over a three year agency engagement I delivered the full technical audit, the keyword architecture, 123 completed page optimizations, two large competitor gap analyses, and the migration QA that inventoried 2,472 legacy URLs through a complete 2022 site rebuild. By the August 2020 fix cycle, the site's SEMrush health score stood at 85 percent with crawl warnings down 460 in a single cycle.
Results SnapshotThe Situation
The Challenge
Red Mountain Weight Loss was a growing multi-location medical practice competing against national brands like Nutrisystem and WeightWatchers, but its website was working against it. The October 2019 audit found the site's authority fragmented across five separately indexed properties: the main www site, an arizona subdomain with 555 indexed results, a texas subdomain with 140, a dev site, and a treatment-specific microsite. The subdomains passed visitors along with meta refreshes instead of 301 redirects, so none of that equity consolidated. Worse, the dev site and a publicly downloadable 1.9GB site backup were both sitting in Google's index.
Indexation was bloated past 1,700 pages against a much smaller real site, inflated by HTTP and HTTPS both resolving, parameter duplicates, and indexed image attachments. On page, 280 pages carried duplicate H1s, 211 had multiple H1s, and 772 of 835 images, 92 percent, had no alt text. There was zero structured data markup site-wide. Core weight loss service pages averaged about 300 words against a 650 word site average, while a single doctors page crammed roughly 9,000 words onto one URL, and PageSpeed Insights rated core pages slow.
Then, in late 2022, came a second challenge: a full site rebuild with changed URLs that put three years of accumulated rankings at risk.
The Work
What Was Done
An audit that became the roadmap
The engagement opened with a full technical audit in October 2019, every finding scored priority 1 through 4, covering the fragmented subdomains, index hygiene, on-page defects, thin content, and speed.
Architecture built from competitor data
SEMrush organic position pulls across 12 plus competitors, from national diet brands to regional medical and med spa sites, fed a 429 row site taxonomy spanning 437 sections and a curated set of 457 target keywords with long-tail and question variants.
On-page optimization, batch after batch
Title tag, H1, and internal linking rewrites started with the highest value location and program pages; tracking workbooks logged 53 pages complete by October 2019 and 123 complete by April 2020. An HTML sitemap of the 89 keeper pages and breadcrumb markup mockups followed. An August 2020 dev fix cycle worked through 10 issue categories, including 75 internal redirects, 28 multiple-H1 pages, mixed content, and missing HSTS on two subdomains.
A content engine grounded in search data
Two keyword gap analyses, April 2021 and a February 2022 refresh, distilled roughly 120,000 competitor keyword rows into 6,199 optimize-existing-page targets and 1,501 create-new-content targets. Twenty-four keyword-mapped content outlines went out across six batches in 2021 and 2022, and a blog audit scored 635 URLs with a blended Analytics and Search Console rubric to decide what to update, consolidate, or leave alone.
Schema and local visibility
FAQPage JSON-LD was written for four pages promoting a flagship body contouring treatment, including three city pages, on a site that had launched the engagement with no structured data at all. A Google Business Profile playbook laid out posts, offers, products, and Q&A per location, and CMS activity logs show hands-on page edits directly in WordPress.
Migration protection for the 2022 relaunch
Before launch, a 97 item pre-launch audit of the WP Engine staging site flagged changed URLs, missing metadata, and 4xx errors. The full legacy site was inventoried at 2,472 URLs and 1,503 images, and 1,866 legacy URLs were re-verified after launch with Search Console API data joined to crawl results. That check caught 20 redirects landing on 404 pages, URLs carrying real accumulated search history, including the Oklahoma City location page, and flagged them for repair before the equity was lost. A post-launch audit one week after relaunch caught 712 multiple-H1 pages, 40 duplicate titles, 7 stray noindex tags, 66 broken redirects, and a redirect bug appending double slashes.
The Payoff
Results
The figures below are from the SEMrush Site Audit report for redmountainweightloss.com dated August 25, 2020, the cleanest windowed snapshot in the engagement records. This was a team engagement, and these numbers describe the site's technical health during that period. Exact traffic figures and target keywords are confidential to the client. Performance data available on request.
| Metric | Before | After |
|---|---|---|
| SEMrush site health score | 81% | 85%, up 4 points across the August fix cycle |
| Crawl warnings | 635 | 175, down 460 across the same cycle |
| Broken pages, 4xx and 5xx errors | 0 | |
| Duplicate title tags | 0 | |
| Broken internal links | 0 |
For a site that started with five fragmented properties, an indexed dev environment, and hundreds of heading and metadata defects, a clean crawl with zero broken pages and zero duplicate titles marked a different technical baseline. The engagement's final phase protected that foundation through a full replatform, with every legacy URL accounted for at launch.
Tools used: Google Search Console including the GSC API, Screaming Frog SEO Spider, SEMrush, Google Analytics, PageSpeed Insights and Lighthouse, W3C validator, Google mobile-friendly test, WordPress with Yoast SEO, WP Engine staging
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