Big trueing about the health issues system being great foundation for expansion.
I don't want outright death in the game, but my messed up mind think it would be hot if you or one of your (lets be real about what we're doing here) victims could end up hospitalized due to a heart attack or chronic kidney disease developing into kidney failure.
I have no idea why it's so hot to me (and I am a little ashamed about it), but I unironically wanna be able to get the player character or a lady to the point where she's dependent on oxygen, face covered in pimples, armpit and crotch hair thick and bushy because she refuses to let the care staff shave her, constantly covered in food detritus, and health so bad that she ends up in the hospital for something weight related at least once every month or two and all the doctors at said hospital know her as THE land whale and they have no idea how she's still alive.
But yet, most crucially, still happy despite it. It isn't fun anymore if they're not having fun. It's why I still really hope we eventually get the option to "corrupt" personalities into more feederism oriented versions of themselves, because they all eventually get to the point that they're clearly afraid, upset, and practically begging you to stop doing what you're doing to them, which both makes me feel bad and turns me off.