I've had this happen to me with asparagus and different produce. Cashiers didn't know what they were.
I was in eating disorder treatment with a girl who became anorexic after a gastric bypass. The staff said it's becoming more common.
Having been in treatment for ED, and now I'm "in recovery"...sometimes something bad will happen and my first instinct is not to run to behaviors. Which, in and of itself, is HUGE. And I do have coping skills. But sometimes, I just sit there like, fuck- what do I do now??? I can see how some of these patients fall into depression during the process.