Besides, there's Dark Souls if you want the super ultimate difficulty. That, or games like I Wanna Be The Guy or Cat Mario.

Ultima VII (I can't recall which part, though) hadsuch effects in a couple of environments. You needed some scrolls of chilling in some hot rat cave and fur hats (at least) in the icy parts of Britannia (or Serpent Isle).

I think I'd love the Frostfall mod, but I don't want to bother with installing N prerequisite things; some UI changes, some scripting stuff, a mod manager ... I use the "pretend" mod instead: I make sure my characters equip fur armor in cold environments and don't swim fully equipped. They can only carry stuff they could wrap in some waterproof(ish) container and I pretend they keep that stuff above water as much as possible.

But if the vanilla game had such "hardcoe roleplaying" options, I'd be all over them.