I played in hardcoe mode and just finished the game and at no point was I ever worried about starving to death, dying of dehydration, or succumbing to exhaustion, although I did have to monitor those things and deal with them on an ongoing basis, they never impacted me in a major way. Additionally, while ammunition had a weight, I didn't think it was realistic to be able to carry upwards of 300 pounds of gear, particularly without power armor, mainly due to issues of volume. I can comfortably carry about 80-110 pounds of equipment/gear on my back and mounted on the front/chest area of tactical body armor, along with the 20+ pounds that the armor itself weighs, but it begins to become a volume issue, there's only so much volume any given pack can handle. Also, it should go without saying that the more you carry, the slower you are going to move. There shouldn't be an expectation that the character can move as fast with 299 pounds of gear (one pound under the 300 pound max limit) as he can with just his shirt and a pistol, why doesn't movement speed gradually decrease as pack weight increases?
Armor weight should only count against your weight/carry limit for one third or one fourth of what the armor actually weighs, since most tactical body armor is nicely and evenly distributed across the chest, back, shoulders, torso, etc, it doesn't feel like 20-25 pounds in any one particular location. That said, the weight carry limit should be set around 120-160 pounds, with possibilities to increase it due to strength enhancing implants, wearing power armor, having better packs, etc.
I often wonder how the main character can physically carry six or seven rifles/shotguns and still remain combat effective, in reality he'd be running around with six rifles slung and one in his hands, and he wouldn't be able to maneuver or change from prone, to kneeling, to standing, etc. He wouldn't be tactically flexible.
In future Fallouts you should probably have use of a "Pack Brahmin" which will serve as a pack mule and carry a half-dozen of your rifles, while you are only able to carry a set number of weapons on your person at any given time. I'd say the limit should be one shotgun (not full length, but rather something along the lines of a breaching weapon, a pistol grip pump, see the Remington Witness Protection model) in a holster on your back (or attached to a carbine/battle rifle along the lines of the Remington Master Key system), one rifle (with a bayonet), three pistols, and several knives.
Item weight isn't the only factor in determining what you can carry because packs have a limit on volume and there are only so many places on the body to strap a weapon or place gear.
Fallout 3 was ridiculously easy, Fallout New Vegas was somewhat more challenging. Taking down the entire vault full of fiends, on my own, wasn't particularly difficult, but I wouldn't expect it to be difficult for somebody who knows what they're doing to kill a bunch of drug crazed freaks who are little more than thugs with guns. I brought companions along but I had them hang back and I simply used them for carrying weapons and gear that I looted from dead fiends. I took down every single fiend in the bunker, mostly with my 5.56mm carbine and my .45-70 gov't lever action rifle.
I had a problem with the anti-material rifle, the .50 BMG, how sometimes torso shots would only do a few damage to a target... The longest shot in history, about 1.52-1.53 miles, made by a Canadian sniper in Afghanistan, was a torso shot, and the guy was instantly killed, because that's how powerful the round is, that's how much power it still has even at 1.53 miles. If you get hit above the waist you're almost certainly going to instantly die due to the hydrostatic shock/trauma that will be caused to the head due to the force of the impact. If you are hit in the leg expect to lose your leg and bleed to death. The .50 BMG was really underpowered in the game in terms of people being able to survive being shot in the torso once or even twice. Also, it doesn't matter what the load is, since standard .50 BMG ball (as opposed to High Explosive, High Explosive Armored Piercing, Armor Piercing Incendiary, etc) is itself armored piercing. You shoot a vest of tactical body armor with a .50 BMG and it doesn't matter what bullet type you are using, it will go through on the first shot. Hell, the round is primarily intended for taking out light armored vehicles and going through the engine blocs of unarmored vehicles. I would wager that if you had an entry/tactical team stacked up ready to make entry into a building, and the front guy was shot with a .50 BMG, the round would go through his level IV plate, go into his body, exit through his back armor/plate, go through the next guy's plate, and continue for at least four or five guys.
Bottom-line suggestions for Bethesda...
The game was a bit too easy and you could use a guy like me (perhaps me) for a weapons consultant for your next game. I have a lot of practical and theoretical knowledge of weapons/ballistics, I like the genre/game series, and I'll work cheap. I appreciated the presence of real weapons that we all know and love (well perhaps that all of us in America at least have an opportunity to know and love) such as the Browning HP pistol, the AR-15, the M4 carbine, the 1873 Winchester, the Colt Single Action Army, etc. Still, the weapons left room for improvement.
I have a friend, a former Marine, who was instructed in all manner of primitive survival and urban/close quarters combat on Uncle Sam's dime, and he can pretty much go into the bayou, the desert, the woods, or the desert, with just a knife and thrive in regards to living comfortably, having a fire, making traps, hunting implements, staying hydrated, etc. Somebody such as him (perhaps him) would be quite a consultant to have for issues dealing with survival and hardcoe mode survival for future Fallouts.
There was really no point in the game when I felt I was going to die unless I could put the characters survival skills/perks to use to stay alive. The points put into survival skill were essentially wasted points as there was no challenge of survival. One problem that should exist with a low survival skill should be mistaking poisonous food for edible food, since everything in the wasteland that you could pick off of a branch or dig out of the ground was edible and safe, that's just not the case.
Overall the game was a low-mid B, maybe an 82 or an 85 out of 100, fixing the bugs will raise it up by a few points, but it wasn't the same as say Fallout 2 or even Fallout 3. Fallout 3 had quests that were much more compelling and gripping. That said, I really did appreciate the ending of Fallout NV as it tied up all loose ends and showed the repercussions of all the seemingly small decisions made throughout the game. In regards to that aspect of the game, Bethesda hit a home-run on that.