Given the sorts of horrors that the Winchesters encounter on a daily basis, I was a bit surprised that the not-very-gory meat factory in 12×18 was enough to put Sam off his food. But then I remembered this scene from Season 7 – a hallucinatory glimpse at Sam’s time in the Cage – and, yeah. Okay.
Sam reacting to the cut up lizard.
Sam upset about the man being carved up.
Sam dislikes dismembered flesh.
I think it’s no coincidence that these reactions are occurring in seasons where Lucifer or his memory are active.