I'm suffering from the same problem, the game is unplayable like this:
That's with all settings maxed out, looks (and runs) the same with everything at low though.
Using the -maxmen option didn't change anything for me. I also used msconfig to limit Vista to 2 GB but that didn't improve things either.
But I noticed that ArmA detects localVRAM=262334336 (that's around 256 MB), I actually have a card with 1 GB though. Maybe that is causing the problem? Unfortunately changing the value in the arma2.cfg doesn't work as it gets overwritten as soon as ArmA starts.
My comp:
i7 920 @ 4.2 Ghz
12 GB RAM
2 GTX 285 in SLI
ArmA installed on a SSD
Vista x64