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Wait I thought you looked worse the longer you went without feeding?
https://www.youtube.com/watch?v=a5d9BrLN5K4
None at all. Unlike e.g. Dishonored where killing enemies has an effect on the world it's not the case in Vampyr. Only civilian NPC are important for the story and overall world status.
On the other hand you could say killing the militia and monster is balancing each other out. At least killing lesser vampires should have a positive effect on the world ;) But to be honest: just don't think to much about it anyway. The hordes of monsters in the streets of london are unrealistic in the first place.
@OP
Every single NPC is related to one quest. But i'd say you are safe to feed on them (without breaking quests) as soon as you finished their quest. Looks like they are of no importance afterwards.
Take Clay Cox as an example: i wouldn't kill him after your arrival. But as soon as he got his knife back and you unlocked his (3?) traits there isn't any reason for him to stay alive - if you want to feed on people. Which is pretty much possible after the first rest in the hospital, because all his traits are easily unlocked.
Makes no sense and makes not want to feed on anyone. And it better explain Ashbury and other vampires looking normal.
I doubt that there's really any real in-lore explanation for this, esp. because mesmerize seems to be less of an in-lore feature but just a balancing mechanic forced into the lore.
But e.g. Ashbury is feeding on people who want to die. You are feeding on people against their free will.
Certain chars. will go feral/stop providing services if you eat someone special in their circle. But not always.
From a gameplay point of view, the only character I've tested that will affect you gameplay wise is if you embrace Pippa, afterwords Milton will stop providing merchant services. I can assume the same happens if you devour the blind guy, his sister will do the same? Just guessing at this point.
Normally it's better to kill the whole family, since if we let only one alive that one might be lost for some other reason, since they wouldn't be taken care anymore or have no reason to stay in the city. And combat in this game can be very punishing or incredibly easy depending on how much time you spend talking to NPCs and killing them afterwards. To keep myself to the same level of the enemies I had to kill a big portion of NPCs, so I imagine that people that want to keep the districts healthy would spend a lot of time killing thugs and skals in the streets, which is possible to do.
I also didn't know the "Pillar of The Community" dynamic, so I killed the first one the first time I had a choice, since she had discovered about vampires, or at least discovered a vampire woman was killing people and I though it was dangerous to let her alive. We also kill our own sister as the first victim, so after all that I didn't see much reason to not kill other NPCs, even more because they were not very likable in the first place. In the end I left the rich people alive because they were the ones that knew me personally and because they were the last I had contact, when I didn't need experience anymore. I started killing based on moral choices, but in the end it was purely pragmatic. I didn't finish the game yet, but probably I will get a bad ending of sorts.