I would like to think most or all people are using the hot water bottle for supplemental, but non-essential, heat. You can choose to boil the water or simply warm it up depending on the temps and your preference.
Toes always seem to be the first thing getting cold. It's much appreciated when it's -7° outside. Even with down booties, those toes and feet can still get chilled. The hot water guarantees they'll stay warm, and heating up 60° water in the morning is much easier and fuel-efficient than heating up a slushy 34° water!
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