Realism has no place in these discussions; the game is an RPG. If people died in like 2 shots Counterstrike-style the combat would be absolutely godawful.
That's kind of where I'm at. Balancing has it's limits, a tweak in one spot could throw off something enjoyable in another. The guns are great, but I've been incredibly successful with a current melee build. I think the paths to a good character are just that much more focused now. My first character was a sci-fry laser geek and he could kill anything. I stood straight in front of the legate with a Plasma Defender and killed him in VATS. You really don't have the ability to wander in your character path though, the whole time I was gearing him up for an energy weapons trip. They are a little weak but I was getting great crits--- in fact by the end of the game I was hitting the Meltdown so often it was frustrating to try and avoid killing my NCR pals.

I could snip a deathclaw with an upgraded Laser rifle.... so I don't see what the big deal is. I like the feeling of getting a character up their in the 20's and being able to stomp just about anything. You can still get into trouble if you're reckless, but it's fun. By level 30 you're the top of the heap, the reward is then the ability to walk headlong into anything and tear it up.
Nerfing the Fat Man is stupid though, I walked around with it the whole time in FO3 but saved it for some dire special occasions. Maybe I used it to scale the capitol building and kill the super mutant behemoth inside, a couple Enclave vertibirds.... and my only other moment was my favorite. When I opened the doors to the mothership Zeta I fired that svcker up the bridge and instantly killed the captain and several of his underlings. That's what that gun is meant for, you don't just clip everything with it.