Okay, literally right after I finished posting that the patch downloaded and proceeded to throw all my changes in the bin. It left me back at square one with me being totally unable to adjust any settings.
Man that sucks,,, and is strange.
By strange I mean, today is when I made the changes. The patch came yesterday. I have had no problems with the settings sticking. They are now just like they were earlier today when I fixed it.
Not sure what would be causing yours to change and mine to remain???
I only have the 'My Games' Fallout.ini set to Read Only. The two FalloutPrefs.ini are open.
Just to make sure nothing funny was going on, I did restart the game using the Launcher and all is still fine like it should be.
In Steam > Library > Fallout: New Vegas > RMB > Properties > Updates: is set to Always keep this game up to date.
I hope you can soon figure out what is happening, especially since you are the one that posted a fix that has (so far) worked for me.
At least there is hope, since my game is settings are sticking (again, so far).