If I wanted to create something that looked exactly like a photo I think I'd be more likely to use a camera than Poser.

Realism - as in body shape rather than wonky eyes or elbow bends - depends a lot on what you're used to. Where I'm from people are generally tall and blonde. And because a lot of the people I know are dancers most of the people I see every day also tend to be slim and have good muscle definition as well. So for me figures like V3/4, M3 and Anastasia are a very good start for me to create what to me seems "normal". And that's also what I want for fantasy and sci-fi renders, so for me the figures I use are very good.

Obviously the same isn't true for everyone and depending on what you're used to, you have a different idea of what's realistic.