Well, there seem to be lots of tards that think Realism > Balance, so lets fucking add some new stuff.
-You need to buy food, cook it and it eat in game, if you dont want to cook it yourselves, you can hire a chef or something, but it will take the same time as it would IRL, otherwise it wouldnt be realistic. If you dont eat, your stats gets lowered, and eventuelly, your character will starw to death.
-You need water, sometimes you will need to take a break from the fighting and bring out that bottle of water, but you need to find clean wather, OTHERWISE...
-Diseases, you can get it from bad water, bad food, wounds or just totally randomly. Lowers stats, some diseases leads to death, some to permanent injuries, like blindness. If your character gets really ill you should not be able to play with him until he's well again.
- You will need to take breaks to take a crap
- You must keep your character happy, otherwise his/her moral wont be as high and he/she will fight worse
- Sleep, of course your character needs to sleep, 7 hours a day would be enought. You will have to find somewhere to sleep before you log out. The character can have sleeping problems.
- Mental Illness, your character can of course be traumatized by all the violence and death and horror that war brings. Maybe he gets som Post-Traumatic Stress and goes shitscared when you do battle and starts running away, or you just get a psychosic and start seeing and hearing stuff that arent there. Your char might get deppressed, wich will lower stats.
-Death, if your character dies in battle, its gone. You aint fucking Jesus