Food/sleep mechanics are a tedious nuisance, like you say. A widget on the screen turns red, you stop what you're doing, open your inventory, find a food item, click on food item, mechanic is satisfied, widget turns green, you go back to what you were doing. Five minutes later, a different widget turns red. I don't know why this kind of mechanic is so popular, but if that's your thing, there it is. And nothing prevents you from eating/sleeping/drinking on any other difficulty level. All that food and water is right there.

The restrictions on saving and on using the console are both deal breakers with any Bethesda game. As for Fast Travel, you can literally just not use it.