After playing a few more hours in the new Survival, I think it's the best way to play Fallout 4. The water / food thing is not annoying, makes you actually plan more and use everything you find if you take detours. Carry weight means I actually stick to 2-3 guns at most When before I was a walking armory... The game really plays a lot different. Illnesses are rare and I am at roughly +2 antibiotics always in my pockets (and they weight almost nothing). I'm not spamming drugs either, a Psycho Jet is something I consider (when someone rushes me for example or something unexpected happens). Stimpacks are a last resort and I usually carry ~10 with me. And any chemicals make you thirsty (stimpacks, drugs, antibiotics). Water is really important now
But the biggest thing is no fast travel. It literally made the game a million times better! The world feels huge now. And because it's enforced, I'm not even tempted to use it, cause I can't!
Everything is perfect in this mode, even the saving
However, old bugs resurfaced... low poly terrain shows up in many places ("glitch query", some of the bridges, skyroads... VERY annoying). Also Dogmeat likes to fall through the floor and "die". I then need to find him and heal him...
And yes, Boomer in Outpost Zimoja (or whatever it's called) oneshot me Reloading, a small walk from last bed, then jet+fatman in his stupid face fixed that really fast
EDIT: Adrenaline is awesome too! Getting a high dmg buff is easy and then it's fighting being tired with nuka colas And then you're thinking where to go or when to return, to rest, reset and start over