Things were not the typical sunshine and roses for Ruby this week. What started out as a celebration spiraled into a lot of self-doubt, depression and fighting to find the motivation to go on.

She weighed herself for the first time in two weeks, to see that she’d dropped to 323.6 pounds. Jeff pointed out she was losing at a rate of about five pounds per week – which is definitely a healthy rate of weight loss. However, a few days later she went to visit her nutritionist Helen who also weighed her in and found that Ruby had actually gained about 20 pounds, as she weighed in at 355 pounds. She was shocked and just kept saying “no way.”

Her nutritionist, trainers and even roommate Jeff prodded to find out where she fell off. She admitted to not using the OurLife meals, not using her food journal, and not exercising each day. She expressed her anger at the scale, but recognized that the fault was her own.

Following the Food Exchange guidelines can help a diabetic manage a healthy diet.

The food exchange lists were developed in the 1950s by the American Dietetic Association, American Diabetes Association, and the U.S. Public Health Service in attempt to simplify the strict and complicated diabetic diet. The idea behind the exchange lists was to provide an educational tool to diabetics and to help provide structure in meal planning. The key to controlling diabetes is to control your blood sugar/blood glucose level. This system does a great job of outlining what you can do to help yourself to control your blood sugar.

A major downfall to this system is cracking down the complexity in order to implement it into your daily life. Therefore, it’s recommended for individuals to meet with a Registered Dietitian (a certified diabetes educator is ideal) in order to fully grasp this diet and help individualize it to your life and needs. The dietitian will recommend a certain number of daily exchanges from each food group based on your individual needs. You and the dietitian will work together to decide the best way to utilize the exchanges in order to control your blood sugar within your target range.

The Glycemic index was developed as a means of ranking carbohydrates (or carb-containing foods) based on their effect on blood sugar level. Foods with a high glycemic index value tend to raise blood sugar levels faster and higher compared to foods with a lower glycemic index. Rapid increases in blood glucose are potent signals to the beta-cells of the pancreas to increase insulin secretion. Over the next few hours, the high insulin levels induced by consumption of high-glycemic index foods may cause a sharp decrease in blood glucose levels (hypoglycemia).

In contrast, the consumption of low-glycemic index foods results in lower, but more sustained, increases in blood glucose and lower insulin demands on pancreatic beta-cells. However, this does not necessarily mean that a low-index food is healthier than a high-index food.