I was curious about this myself recently and a conversation with my wife managed to clarify it a bit for me. She's very technically proficient but is not a hacker. She also uses Word for almost everything, which drives me crazy, but I think I understand why now.
To her content and presentation are not separate entities. Font choice, heading size, margins and spacing, and colors are secondary to the text and the document structure, but they're still semantic elements and carry meaning above and beyond the structure they present. Presenting a sentence in red, for example, conveys a different meaning than making the same sentence bold, even if in theory they're simply alternate ways of conveying importance. She judges the extra expressiveness to be worth the extra complexity, even for informal documents and notes to herself.