Don't drop your guard . . . ever

If anyone's going to get their kit off in public at the age of 71, I'm sure you'll agree that it may as well be the delectable Sophia Loren. On 5 July it was announced that the actress had posed for that annual paean to the female form, the Pirelli calendar, prompting much praise from cultural commentators. In accepting the assignment, they argue, Loren is striking a blow for older women, making them sexually visible in a society that adores youth.

This is partly true. I can't help thinking, however, that the sexual viability of older male stars - Jack Nicholson, Clint Eastwood, Harrison Ford - has never been contingent on them stripping off. But, if Loren wants to do so, then why not? I have no doubt that she'll look gorgeous, toned and perfect in the entirely transparent frock she's rumoured to model for the calendar. The woman has enough va-va-voom to power a cruise liner.

Yet something about the news made me feel slightly exhausted, just as I did when Felicity Kendal was pictured naked recently. Kendal looked great - no arguments there - but her photograph rammed home a wider cultural message. On no account, it suggested, can anyone now - and especially any woman - afford to let her guard down.

Where once it might have been acceptable to reach 40, 50, 60 or 70 and to relax, enjoying life's simple pleasures and ceasing to worry about a bit of sagging and bagging, such joie de vivre has been replaced by a distinct moral puritanism. To let yourself go, to eat badly, to hold off the exercise, to smoke, drink and carouse, have become the greatest crimes of all, making you instantly déclassée. And because the physical effects are often visible, all those who succumb are modern Hester Prynnes, forced to trail their shame.

Which accounts for the endless make-over shows on TV in which posh girls like Trinny and Susannah berate people for, uh, not looking sufficiently like posh girls. With their upper-class presenters and working-class subjects, the message is: we look after our image and health with regular trips to Harvey Nicks and holistic day spas, so why, oh why, can't you?

The huge disgust we direct towards those who let themselves go also accounts for a recent survey of British doctors which found that 40 per cent believe in withholding National Health Service treatment from smokers and drinkers, and would deny essential joint treatment to the overweight, if resources were limited. Make the bastards pay!

Though this makes some sort of sense in cases where personal indulgences will end in, say, a patient drinking his way through a liver transplant, it seems otherwise unbelievably punitive. I understand that there's an equivalence that appeals to some here - if someone smokes, deny them lung-cancer treatment; if someone eats too much, deny them joint treatment - but, given that withholding medical help is one of the toughest penalties a society can pronounce, it also suggests there's now nothing we find more morally abhorrent than over-indulgence.

All of which is even worse when you consider the class aspects at work.

Denying yourself life's simpler, cheaper pleasures - smoking, drinking, eating sugar-rich foods - is all very well if you have a fulfilling job to sustain you through the day and can afford to treat your starved palate at night with a trip to the Fat Duck in Bray, Berkshire (where many of the customers, I suspect, do indeed bray).

If you work in a factory, however, smoking and drinking can seem almost a necessity - and, yes, I have worked in a factory myself: packing toilet ducks, as it happens. The thought of letting yourself go in the evenings can be one of the few things that gets you through the day.

Don't get me wrong: I think it's great that a growing interest in health is allowing many of us to live longer. A level of personal pride and responsibility is undoubtedly a good thing. But when that self-interest becomes all-consuming and emanates outwards, implying that anyone who isn't similarly disciplined is both physically and morally repulsive, then the situation becomes ugly indeed.

After all, there are many faults worse than a bit of over-indulgence or personal ill-discipline, including, I would argue, intense self-interest, self-righteousness and moral triumphalism. Being a self-satisfied healthy prig who can kill a party at a hundred paces isn't exactly the greatest of qualities.

In arguing that over-indulgent people shouldn't get free medical treatment, some doctors cite the poverty of the NHS, and suggest that the only way to alleviate this is to shut out those whose conditions are self-inflicted (but who have, it should not be forgotten, often paid huge taxes on booze and fags in the process).

A much better solution, I would have thought, would be to slap higher taxes on salaries over the £100,000-per-annum mark, and to make sure that all the multimillionaires/billionaires out there actually pay the state what they owe. But then again, I'm suffering a bit of a hangover and am about to eat a leftover sausage for breakfast. What the hell do I know?

Kira Cochrane is the Guardian women's editor