Is Revit MEP worth all the trouble and expense
Yes
or is AutoCAD MEP just fine.
Yes, its only fine
Do you have to be a heavy MEP designer to get your money's worth?
Define heavy.... I am 70kg.
But really, what else do you do? If you are working in a multi disciplined environment Revit is even more valuable.
Where is the break even point?
The break even point occurs when local Architects start giving you sole select work because you can deliver your design in the same platform they are using, fully coordinated into their model. The trick is to get there before your competitors so you dont have to try to win what were your customers back when you are finally up to speed.
The learning curve is massive. Be prepared for some very late nights.