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The treatment of Avoidant Restrictive Food Intake Disorder (ARFID) is primarily based on behavioral intervention and no high-quality evidence exists supporting efficacy of medications. However, low quality evidence in previous retrospective and case studies indicate possible benefits of Olanzapine. We present a nine-year old female with ARFID who presented to the inpatient pediatric unit twice with severe food refusal leading to severe metabolic abnormalities. Addition of Olanzapine to Fluoxetine, and behavioral intervention not only resulted in significant improvement in feeding within few days but also reduced the length of hospitalization. Large randomized controlled trials are suggested to derive conclusive results.