IMO food would be a lot more interesting in general if it was necessary to survive ala Fallout.
Yeap, you actully have to take gear and plan if you need to drink/eat and repair your gear, may not be challenging but it makes use all the game offers and other wise all that stuff is just pointless waste of weight, as its not like its worth any money.
A lack of cause and effect detracts from the immersive believability of the world, i found my self alot more focused on rp and my character(ala NV) when there were more causes and effects to create a more believable sence of time passing, things happening, how ever small.