i actually find trying to add much realism in a game takes AWAY from immersion, mostly because it is always done really badly and is actually impossible to do in a video game that is not like the sims series, no exceptions. It also takes away from the point of the game to me, the adventure, the story, and the ability to create characters how YOU/I want instead of now trying to keep your character up with trying to keep with the realism.
Another major thing many here to not understand is that just because it does not happen to your character or it is not in the game, it is not what would really happen. For example, a major complaint i see is, "how am i able to survive in the snow, i should be freezing to death", and then act as if that is how it would ACTUALLY work if that game was real instead of being just for gameplay purposes.