Maybe I'm just strange, but the eating itself can give me a sense of accomplishment in a game.
Imagine: freezing, dark winter day, you leave your campfire in desperate search for food. You come on a lake and use your axe to hack a hole in the ice. You spend the next 4 hours ice fishing with little skill and crappy equipment, but finally manage to catch a nice 2-3kg pike! Before you're back at the camp, you've got some frostbites on your hands, and the fire has gone out. Good thing you were smart enough to store some firewood. With your long survival experience you manage to light the fire again, even with the icy wind, snowy pieces of wood and frozen hands. You melt some snow and boil water while the pike is roasting, and treat your hands with warm water and bandages. The pike is delicious, and gives you strength to carry on your journey for another day.
I find this to be an example of realistic, challenging but still rewarding and fun gameplay. The same game includes several damage types, such as blunt, piercing and slashing, different armour values versus different damages, hit locations, wounds according to damage: bruises, fractures, punctures, cuts, even dismemberment. Survival elements with tracking, hunting, trap making, fishing as you already know, food preparation, wound treatment, item making, mainly crude weapons and bandages but also rafts, shelters and houses. You can chop down trees to make yourself that precious firewood, and you can skin the animals to have fur to help you survive the winter.
I'm not asking too much if I want the same things in TES5? Wouldn't that be like, you know, WAY better than some RAI or other lame old crud you see in every game?
See, that wouldn't excite me at all. I don't enjoy spending a lot of time "just staying alive". I already spend 11 hours out of my day dealing with "crap I need to do just to live", and it's not particularly what I want to do when I'm trying to escape RealLife (the ultimate in realism games!).
What I enjoy is having a lot to do and see without having special mechanics involved. For example, I would love it if there was a long, deep, and dangerous cave that contained a unique and useless item at the bottom. Because utility is something I want out of my weapons and armor, but uniqueness is what I like in my "rewards for excessive stupidity". If I'm going to crawl through a gauntlet of the nastiest of nasty creatures, slash my way through hordes of daedra, and spend three hours navigating a maze, what I want is something I couldn't get elsewhere. I don't care if it's a dagger that consumes magicka to deal damage, armor that protects from lightning, a set of threads that makes me mostly invisible, or a ring that makes people like me more. As long as it can't be gotten elsewhere, it could be armor made of lead, a bowl made of wood, or a book of terrible jokes. It's the one-of-a-kind I enjoy about such excursions.
Or, it could be simply the fun and challenge of leaping from building to building to get to the highest point in a city, then doing medieval base jumping, because Oblivion cemented that as a Tamrielic sport
(side note: this is why I don't like Levitation!)
But what I like most is going places and finding notes, stories, and "stuff to do".
I want a quest where you have to play multiple roles to steal something... OUTSIDE the Guild. Make me infiltrate a location and steal something, and barge in somewhere else and beat people senesless, and charm someone into spilling secrets, and use magic to disrupt the mystical protections around an object or person, and make me outwit an investigator in the process. Not ONE style of thievery, but many. All for one quest. I want notes everywhere. Old scraps I can't read, new scribblings I can, inscriptions on buildings, paintings that reveal secret messages when using Nighteye. Every place should have a story of some sort, whether explicit (notes), or implicit (trails of blood leading up to a wall, then when you find the opening to the secret way, there's a skeleton/zombie/corpse where the trail led... or there's another dead end). Just something to reward me for going into a dungeon. Maybe it could be goblins worshipping an apple, or polar bears in Skyrim that are sitting around with bottles of beverages nearby. Every location should have something to read, do, see, or hear. Profound or mundane, it gives each place a sense of individuality.
I think Bethesda has "got" the need for little gags, amusemants, and stories, given Fallout 3 and Point Lookout. But that's what I play for: go where I want, do what I want, with minimal requirements upon me. That's why a survivalist bent to any and all travel rubs me the wrong way. It requires me to do things unrelated in any way to what I want to do. That's why I say "optional with reasons to want to do it" is better than "make it core gameplay". Simply put, my biggest accomplishment in Oblivion is "90% book completion". That is, I confiscated volumes of most of the books in the game (and whitewashed any stolen volumes!). And I enjoyed getting together a list of places from UESP and goign on a rampage of theft to complete a few series. What I'd really like is the ability to use informants to keep the "finding stuff" part in-game.
Say, "I'm looking for a rare book". A begger might say "The Count had a very rare book, but it was stolen". Darn. Guess I got that one already. But then I ask an innkeeper, and he tells me "Word is that the bookstore has a volume that isn't out on the shelves.", and I can now try to go buy it, or failing that, steal it. But I probably don't want to steal it right away, because that SHOULD make people suspicious.
Not quite what you're looking for, is it? But it works for me.