Persistent negative free cash flow, which reached an outflow of $22.5 million in 2026Q1, underscores a structural reliance on external capital to fund operations.
| Cash from Operations | -87.73M | -90.33M | -65.52M | -42.82M | -46.24M | -33.46M | -31.07M | -27.73M |
| Operating CF Margin % | - | - | -70452.69% | -35685.83% | - | - | - | - |
| Operating CF Growth % | -53.94% | -37.86% | -53% | 7.4% | -38.2% | -7.69% | -12.06% | - |
| Net Income | -108M | -140.95M | -68.69M | -77.09M | -46.45M | -38.73M | -30.48M | -30.59M |
| Depreciation & Amortization | 1.12M | 1.13M | 677K | 286K | 452K | 676K | 770K | 893K |
| Stock-Based Compensation | 5.28M | 6.68M | 14.43M | 4.3M | 3.14M | 2.09M | 1.63M | 2.52M |
| Deferred Taxes | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Non-Cash Items | 16.86M | 43.21M | -21.52M | 28.7M | -2.14M | 795K | 517K | 274K |
| Working Capital Changes | -2.99M | -395K | 9.59M | 989K | -1.24M | 1.71M | -3.51M | -824K |
| Change in Receivables | 0 | 0 | 22K | -22K | 0 | 0 | 0 | 0 |
| Change in Inventory | 0 | 73K | 0 | -73K | 0 | 0 | 0 | 0 |
| Change in Payables | 170K | -1.67M | 2.69M | -427K | 0 | 666K | -304K | 0 |
| Cash from Investing | -109K | -557K | -1.76M | -359K | -56K | -51K | -2K | -97K |
| Capital Expenditures | -109K | -557K | -1.76M | -359K | -56K | -51K | -2K | -97K |
| CapEx % of Revenue | - | - | 1897.85% | 299.17% | - | - | - | - |
| Acquisitions | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - |
| Other Investing | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Cash from Financing | 108.89M | 104.96M | 101.23M | 27.44M | 4.35M | 99.88M | 54.39M | 15.16M |
| Debt Issued (Net) | -471K | -457K | -187K | 28.35M | 4.03M | -7K | -7K | 14.95M |
| Equity Issued (Net) | 109.37M | 105.42M | 103.69M | 0 | 321K | 99.85M | 54.37M | 0 |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Other Financing | 0 | 0 | -2.28M | -911K | 0 | 40K | 24K | 217K |
| Net Change in Cash | 21.06M | 14.08M | 33.94M | -15.74M | -46.2M | 66.37M | 23.32M | -12.66M |
| Free Cash Flow | -87.83M | -90.89M | -67.29M | -43.18M | -46.3M | -33.51M | -31.07M | -27.83M |
| FCF Margin % | - | - | -72350.54% | -35985% | - | - | - | - |
| FCF Growth % | -9.73% | -35.07% | -55.82% | 6.73% | -38.15% | -7.85% | -11.67% | - |
| FCF per Share | -1.16 | -1.20 | -1.55 | -0.91 | -0.97 | -0.70 | -0.65 | -0.58 |
| FCF Conversion (FCF/Net Income) | 0.81x | 0.64x | 0.95x | 0.56x | 1.00x | 0.86x | 1.02x | 0.91x |
| Interest Paid | 1.04M | 0 | 3.13M | 762K | 0 | 1.03M | 1.04M | 0 |
| Taxes Paid | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Clinical trial funding dependency
As reported in financial statements, the 2026Q1 net income of $9.2 million stands in stark contrast to the $22.5 million operating cash outflow, suggesting that non-operating accounting adjustments are significantly decoupling the firm's reported profitability from its actual cash-generating capacity during this developmental phase.
The wide divergence between net income and operating cash flow indicates that investors should exercise caution when interpreting headline earnings, as they do not reflect the underlying cash burn. This disconnect suggests that the company's current financial reporting may be heavily influenced by non-cash items rather than operational success.
Based on recent SEC filings, the company has consistently recorded negative free cash flow, with quarterly outflows frequently exceeding $20 million, highlighting a structural reliance on external capital to sustain operations while the Revita system remains in the pivotal clinical trial and regulatory development phase.
The trajectory of free cash flow remains firmly in negative territory, reflecting the high costs associated with clinical development. This trend suggests that the company is currently in a cash-burning phase that will likely persist until a commercial product reaches the market.
According to quarterly data, working capital changes have fluctuated significantly, ranging from a $5.0 million inflow in 2024Q4 to a $4.5 million outflow in 2026Q1, which complicates the predictability of the company's short-term cash requirements and overall liquidity management during this pre-revenue period.
The erratic nature of working capital movements suggests that the company is managing its payables and accruals in response to immediate cash constraints rather than operational efficiency. Investors should monitor these swings as they may indicate shifting priorities in vendor management or timing of clinical trial expenses.
As indicated by financial disclosures, stock-based compensation has remained a consistent feature of the company's expense structure, peaking at $5.2 million in 2024Q1, which effectively obscures the true magnitude of the operational cash drain by substituting equity for cash-based employee remuneration.
While stock-based compensation preserves cash in the short term, it represents a significant dilution risk for shareholders that is not fully captured in the operating cash flow statement. This practice warrants further investigation to determine the long-term impact on equity value as the company continues to burn through its cash reserves.
Quick answers to the most common questions about buying GUTS stock.
Fractyl Health, Inc. Common Stock (GUTS) generated $-90.3M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Fractyl Health, Inc. Common Stock (GUTS) reported negative free cash flow of $90.9M in 2025, indicating capital requirements exceeded cash from operations.
Fractyl Health, Inc. Common Stock (GUTS) spent $0.6M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.