The Substance is a grotesque takedown of our obsession with youth

As much as studios love hyping up their latest scary movies as being so terrifying that they traumatize audiences, it is rare for features to live up to that kind of buzz. But The Substance writer / director Coralie Fargeat’s new body horror is infinitely more disturbing (a feature, not a bug) than any of its early trailers have let on. 

Films about the agony of living up to female beauty standards aren’t new, but The Substance weaves them into an incisive feminist parable that feels jacked directly into the moment that has given us on-demand Ozempic and Brat. And what the film lacks in subtlety, it makes up for with an inspired — if stomach-turning — story that’s meant to get all the way under your skin no matter how secure in your body you might feel.

After years of hosting her popular aerobics TV show, fitness icon Elisabeth Sparkle (Demi Moore) has almost everything she’s ever dreamed of. She’s wealthy, famous, and her face is plastered all over Los Angeles, where her name has become synonymous with the overt sexiness of her long-running series. On the day Elisabeth turns 50, though, her piggish boss Harvey (Dennis Quaid) informs her that her time with the studio is coming to an end. He insists that Elisabeth’s dismissal is just a consequence of viewers’ changing tastes in programming, but she knows that it’s her age.

Elisabeth understands how, especially in show business, women can become personae non grata the moment men in power decide they’re no longer physically desirable. And the reality that she’s being sunsetted alarms Elisabeth so much that she barely thinks twice when presented with the opportunity to try a mysterious drug that promises to transform her into a “younger, more beautiful, more perfect” version of herself. The Substance works, and Elisabeth gives a twisted kind of birth to Sue (Margaret Qualley) — a gorgeous 20-something whose looks send men into cartoonish fits. But as happy as Elisabeth initially is with her secret double life, she soon finds herself at odds with Sue as “they” struggle to follow the strict rules about how The Substance is supposed to be used.

It doesn’t take many licks to get through The Substance’s glossy candy coating down to its powerful messages about the ways society pushes women to aspire and conform to unrealistic ideas of femininity. The Substance repeatedly explains that Elisabeth and Sue are the same person and must alternate between physical forms for a week at a time in order to remain stable. The conceit itself is an effective metaphor for the way that our youth-obsessed culture drives people to drastically alter themselves with drugs, cosmetic surgeries, and extreme lifestyle changes that all come with some degree of risk.

It’s excruciating to watch The Substance’s visceral shots of skin being ripped apart and bodily fluids being drained through twisted tubing. But as Sue steps out into the world, Fargeat presents it as an intoxicating wonderland of sex and power intoxicating enough to make the pain of her transformation worth it. Though The Substance features a handful of other characters, Moore and Qualley command the film with dueling performances. Together, they paint a complex picture of a woman at war with herself for control of a life that they’re both responsible for but have drastically different experiences of. 

Moore brings a desperate weariness to Elisabeth, whose status as a spandex-wearing fitness icon reads as a nod to the actor’s rise to fame in the early ’80s. And there’s a sociopathic quality to the way Qualley inhabits Sue as a woman merely playing at being a guileless “girl next door” type to befuddle boorish men. As the drug continues to open more and more doors for Sue that were once closed to Elisabeth, The Substance begins to echo many of the beats that shaped All About Eve while channeling a dark eroticism evocative of Paul Verhoeven’s Showgirls. But as Elisabeth and Sue’s fight for more control over their life becomes more pointed, the movie drives head-on into territory reminiscent of David Cronenberg’s Crash and Crimes of the Future, which Fargeat makes her own with buckets of artfully splattered viscera. 

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While there’s a pronounced comedy streak running through it, The Substance is not at all a movie for the squeamish. Many of its most stunning scenes are soaked in blood spurting from unnatural orifices and bodies becoming warped in nightmarish ways. They’re spectacularly nauseating. Fargeat wants you to feel the fantasy and witness the suffering that comes with trying to maintain it. The Substance might very well leave you feeling sick and a little woozy, but that’s how you know it’s working.

The Substance also stars Hugo Diego Garcia, Philip Schurer, Joseph Balderrama, Tom Morton, and Robin Greer. The film hits theaters on September 20th.