Maybe the performance bottleneck for the FNV engine is different than Skyrim, but after a lot of testing in Skyrim I discovered that for me the performance bottleneck in Skyrim was amount of video memory on my video card.
In my case with no mods at all except ENB + SKSE + SKYUI + a few memory mods and an FPS/memory utilization meter I was getting a consistent 60 FPS inside and a horrible 15-30 FPS outside with relatively common dips into single digits. With over 100 mods added + 2-4k HQ texture mods + max quality settings for lighting and visuals, no change in FPS. With DynDOLOD set to very low texture size for distant objects but 2-4k textures for nearby objects and all other visual settings at max I get 40-50 FPS outside and a constant 60 inside.
I'm definitely curious what sort of difference I'll see when I try Fallout again. The only visual enhancement I had to turn off in Skyrim was an enhanced grasses mod that seems to be a huge memory hog.
It's also quite possible that someone with a better computer than mine could have a different bottleneck. My video card is a 2GB GTX 760.
My understanding of the way ugridstoload and DynDOLOD work though makes me think video memory was in fact your bottleneck as well. Increasing ugridstoload basically tells the game to load full sized textures for distant objects. From what I understand, setting ugridstoload higher can also break quests by making the game trigger things that normally only happen when you're close enough to actually see them happening except now you'll miss it.
DynDOLOD basically lets you tell the game to display lower size textures for distant objects instead of the full sized textures so it saves a huge amount of memory especially if you reduce the sizes from it's default. Not sure if there's something similar for Fallout, I haven't looked yet. I'm guessing you'd need a couple of 8GB video cards in SLI to be able to set ugridstoload much higher than 5 without massive performance loss though.
(edit: Out of curiousity I went and looked for a comparable FNV mod and there does seem to be one called Lodgen http://www.nexusmods.com/newvegas/mods/58562/? )
Haven't tried it so no idea how it compares to DynDOLOD as far as ease of use or feature set.


