Which of the following is listed as a cause of aharshanam?

• A. Hypertension, diabetes, obesity
• B. High cholesterol/triglycerides, hypertension, diabetes, obesity, 75+ years, stress, depression, fear
• C. Infectious disease
• D. Regular exercise

Answer: (B)

Aharshanam refers to a disturbance in appetite or a tendency to avoid eating, which can arise from a mix of physical and psychological factors. The best choice includes a broad range of contributors you’d expect to see in appetite disturbances: metabolic and vascular issues (high cholesterol/triglycerides, hypertension, diabetes, obesity) which reflect systemic illness and frailty; advanced age (75+ years), which often brings reduced appetite and altered taste or appetite signals; and psychological factors (stress, depression, fear) that can suppress eating through hormonal and neural pathways. This combination covers both the physical disease processes and the mental/emotional factors that commonly lead to eating difficulties.

Infectious disease can cause reduced appetite but isn’t as broad a listing of contributing factors. Regular exercise typically improves appetite rather than causes a disturbance, and the first option omits the important age and psychological components that amplify risk.