I've been messing with my settings to try and fix these major stuttering problems to no avail. Why? Apparently my video options don't save. I don't know why, but no matter what I select under options gets reverted to the default.

I'll try and set Anisotropic Filtering to none, close the window, and then immediately open the window again to find AF is back at it's default value. Same thing happens to water effects and everything else except AA, apparently.

How exactly can I fix these stuttering issues if the options don't properly save themselves?

Yes, I'm clicking the "okay" button after selecting my changes. I'm not stupid and can change my settings around just fine in FO3, just not in New Vegas

http://www.gamesas.com/index.php?/topic/1122866-graphic-settings-not-saving-fixed/

That works for maybe the first time I decide to play the game, but then the video settings go right back to default.

Start steam in offline mode... then your settings will save properly.

TBH all i had to do was restart steam before i made changes to my graphics settings. I didn't have to go into offline mode or anything. Just a simple restart worked just fine. Of course changing the graphics settings didn't help any of my fps problems anyways. Que sera sera.