After a break, the Red Team is in the elimination room. Jessica says that everyone needs to be there, but she considered medical factors most of all in making her decision. She votes for her BFF Courtney. Courtney voted based on percentage of weight lost overall, and so votes for Vinny. Sami takes this moment to point out that there's a whole lot of tension at the table, and Vinny agrees. He notes that Courtney doesn't have the medical problems that Ramon has, which is why he's voted for Courtney. He points out that her issues lie more with her confidence than with losing weight. Courtney is like, "Duh, I'm fat too." These two go back and forth for a while, but really the decision is quite obvious. Ramon is BFFs with Vinny, and unlike Jessica he won't vote off his bud. He votes for Courtney, and she's officially eliminated. She walks out with no hugs or anything.

Courtney tells us that this is a bitter thing, but still she made it to week five. She came to the competition not only overweight, but insecure. The person who's leaving has found herself and her inner confidence a bit more, and has started to be happy with herself. Courtney is ready to shock the heck out of a lot of people. The next time we see Courtney, she'll be training for a marathon, be thinner than she was in junior high, and will be the most confident Courtney we've seen yet. Courtney started on the ranch at 270 pounds, and now weighs 205. That's 65 pounds lost! Courtney cooks a Biggest Loser Simply Sensible entrée for her sister, and they agree that it's delicious. Courtney is -- ding ding ding! -- paying it forward with her sister, who also struggles with her weight. Courtney's sister has been inspired by Courtney's experience, and then they both cry as Courtney tells her sister about the Fitness Ridge prize. Good times, good times. Courtney plans to travel the world and inspire others along the way.

Next week: Spooky Halloween times! The contestants are challenged to lose 100 pounds together for collective immunity. And there's romance a-brewin' between Jessica and Ramon!