I have actually shot quite a few critters with the vpa heads, both the standard 1 1/8" diameter and the 1 1/4". I have shot both the short stubby 1 1/4'' as well as the somewhat longer profile that the 250 grain heads have. Here are some of my thoughts.
On hogs, I have noticed significantly better and more consistent blood trails using the 1 1/4" heads, but I doubt that I have ever not recovered an animal by using the 1 1/8" heads.
I have found no significant change in how well my arrows fly or tune between the 2 different diameters.
I haven't seen a change in penetration between the 2 different heads, but I may shoot a little more energetic setups than some. I seriously doubt that using the short stubby 1 1/4 200 grain heads will cause you any issue on bear and deer. Now, if you hit heavy bone it may, but then you have other problems to deal with. Honestly with 53#, I have a hard time believing that you would have trouble penetrating elk or hogs as long as your arrows are flying straight, but that is only my opinion. Good luck with whatever you choose. If you have any doubts regarding penetration due to the profile, there is absolutely nothing wrong with the 1 1/8" heads, and I really can't speak to how the heads perform on elk, because I haven't shot an elk yet.