Just include a Realism slider under the difficulty one. The extreme low end would be like vanilla OB or MW, the extreme far end would require eating and drinking and resting as much as a real person, under the same circumstances. So you can dial in the exact amount of realism you want.
It's a good idea, but it's kinda hard to have. I mean, how would one know what difference in actual gameplay a 100% slider would be compared to a 70% slider? Also, things like real hunger, thirst, sleep, etc... they basically just go "turn off and on".
Nevertheless, they really need to add some real explanation of
exactly what the option would affect.