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If you attempt to launch it via GOG Galaxy it will crash right away and then you can't lauch it even by fallout3.exe. But when you delete config files from documents it will work from fallout and launcher exes, but don't you dare to launch it from GOG - it'll broke again.
May be related to problems in Windows. Are you on latest version of Windows 10? If it is a problem in Galaxy, GOG will want to hear about it.
Post edited February 19, 2020 by Themken