Rimworld.

No other game lets you feed people, to people.

Human skin hats? Check

Dramatic survival? Check

Sense of hopelessness interrupted by comedy and/or short sweet success? Check

Taking those who killed your friends as prisoners and harvesting their organs like the dogs they are? Check

Mental breaks that cause your colonists to destroy the entire settlement? Check

Mods? Oh hell yeah, check.

Edit: many games let you feed people to people, apparently, but I could not think of any at the time.

Edit 2: my top rated comment! To the moon! Thanks everyone!