Meh, even on Very Hard, after lvl 5-8 you'll find that you can kill most things with no more than a few crit shots. Player does 50% less damage, but since so many creatures don't have that many hit points (they don't increase w/difficulty), it's still not much of a (combat) challenge after those early moments, especially if you're good at getting crit. hits. Does depend on gear and perks and combat playstyle & all of that, but seriously....most things do not become horrendous bullet sponges even in VH.
That said...for a lot of people, I'd guess Easy or Normal would fit in more with the 'realistic' concept of at least 1-shotting most humans in the face.