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You would literally have to avoid all enemy engagements other than boss fights. Use nothing other than the 9mm tranquilizer gun and only when absolutely necessary. It would also mean having the absolute minimum number of kills.

If you're a hard core Metal Gear player, that's probably the play style you'll choose when you want the optimal challenge. It's essentially taking the fundamental stealth concept of the game to the highest extreme.

Generally you have to know the game like the back of your hand to play that way, so it's pretty impressive if someone can do that within one week of the game's release.

Unless if you're playing over ten hours a day. In which case, that's pretty sad. lol