Maybe it's just me, but I didn't exactly find myself challenged by hardcoe mode. Food and water were plentiful, I've always had sufficient doctor bags and beds aren't that hard to find. Nor is a doctor for rad poisoning, if you run out of your rad-x. Ammo weights are about all that really impact me, stupid heavy .50 cal rounds... Of course, I haven't installed any mods to tweak it yet, either. I probably ought to.
yes, without mods, food and drink are way too plentiful and you only need to sleep about once per week or so.
Here are the mods I used (both are very small and do not impact fps):
- Expensive Wasteland (you can do 2x, 3x, 5x or 10x all merchant prices)
- Harder hardcoe Rates (I went with "refined" rates - there are a couple of other options)
The result was that I was usually suffering from reduced stats as a result of dehydration, starvation and sleep deprivation.