http://amito.freehostia.com/Fallout/FO-mods04.htm comes with a http://amito.freehostia.com/Fallout/FO-mods04.htm#Med-Tec, which includes eating/drinking/sleeping needs, making the healing process a little more difficult, and even add a completely new wounds system with burns, bleeding, trauma and a few other things to keep track off. Pretty detailed, works nicely.
The Med-Tec module can be used separately from the main tweaks, but if you really want a hardcoe survival RPG experience, get them all.

Edit: Actually I think it does require FOSE. You're missing out on lots of good mods if you can't get FOSE to work.