‘The Substance’ Review: Coralie Fargeat Feeds Us Moore Gore in Blood-Soaked Rumination on Female Body Image | TIFF

Women know body horror all too well. Before we can even really grasp what they mean, the standards embedded in us tell us our bodies are not enough constantly. We are encouraged to pluck, scrub, work, and shrink ourselves into something palatable for the wider world. Fit in the small, inconspicuous box of a respectable kind of womanhood, the world says, and you’ll be just fine until you’re too old, of course. To be a woman is to know and sit with this infuriating truth. In Coralie Fargeat’s The Substance, the beauty standards thrust upon all women and the societal indignities we face as we age come together in a gory, glorious work of visceral rage. 

In The Substance, before we meet Elisabeth Sparkle (Demi Moore), an aging movie star, we see the literal passage of time through her star on the Hollywood Walk of Fame. Over the years, the enthusiastic crowds and groups of fans give way to uninterested tourists, and unimpressed citizens, eventually waning down to a snail’s pace of cleaning crews and little else. A crack even forms over the star, her prime seemingly gone. When we meet Elisabeth, it’s her birthday. As she wanders into the bathroom, she overhears her station boss, Harvey (Dennis Quaid) plans to replace her spot on her signature workout TV show with a younger, bouncier girl. She is distraught, tormented by her seemingly past prime, and gets into a car accident when she’s distracted by her face being ripped off a billboard advertisement, ready for the next it girl to come along. 

At the hospital, a nurse passes her a mysterious USB drive labeled “The Substance,” along with a note: “It changed my life.” We learn that The Substance is a medical procedure that creates a newer, better version of its “matrix” — a perfect copy of the person who uses it. They are two halves of the same coin, and whatever one does affects the other — they must switch who is conscious every seven days or one will begin to destroy the other. At first, Elisabeth tosses the drive in the trash, and then she is scrambling back for it, desperately digging in the refuse for a chance to regain her youth. When her younger, perkier self, reborn as Sue (Margaret Qualley) starts taking over Elisabeth’s life, things can only end in blood-soaked chaos.

The Substance is unabashedly and intentionally on the nose regarding ideas about aging, women’s own self-loathing engineered by society, and the pressure we are all under to constantly self-improve. Elisabeth and Sue are technically the same person, and yet, they are at odds with each other constantly. Sue’s increasing disgust with Elisabeth, as Elisabeth spirals and begins binging food to comfort herself as she becomes haggard thanks to Sue’s selfishness, is violent. After one switch, when Elisabeth has finished an extended period of cooking and eating, Sue screams out in horror and frustration at the devastating mess in the apartment, calling Elisabeth “Fat, old, disgusting.” Sue is the worst parts of Elisabeth’s self-loathing made manifest, something that Elisabeth thought she could outrun with The Substance but instead made more powerful. In Sue, Elisabeth’s self-effacing rage is allowed to explode. There are no winners here, and even Sue isn’t immune to the pressures of maintaining her beauty. Towards the end of the film, Sue makes several devastating choices, leading towards the film’s unforgettable climax that seemingly one-ups itself with every passing minute. Just when you thought you’d seen the last stray appendage appear or figured there was enough bloodshed, the screen turns crimson and a new body part appears, unrelenting and chaotically hilarious in its execution. The film reaches levels of body horror on par with classics like The Fly and balances the line between camp and genuine horror like 1981’s Possession, using these influences to create something truly singular and surprising.

It all works, the horror and the camp, thanks to the go-for-broke performances of its cast, chief among them Moore’s as Elisabeth. We watch as Elisabeth disintegrates because of her self-loathing (literally), with Moore donning intense makeup and prosthetics as the film goes on and Sue takes more of Elisabeth’s life force. It is a brave, egoless performance that Moore delivers with confidence and bitter humor. Qualley is equally great, bringing a youthful, ruthless energy to Sue. Sue relishes in her newfound life, and Qualley’s performance encapsulates the fleeting confidence and arrogance that only youth can provide. Even Quaid as the bumbling, ultra-misogynistic Harvey is bringing his all, giving us an unhinged performance that includes perhaps the most grotesque depiction of someone eating food since Denethor in The Lord of the Rings.

The Substance’s performances are uplifted by the truly deranged, smart, and funny script by Fargeat, which holds nothing back. Subtlety isn’t necessary here, because Fargeat wants us to sit with the insanity that all women have to sit with every day under Western beauty standards and because she has a point to get across. It is outlined neatly in the video introducing Elisabeth and us to The Substance: “You can’t escape from yourself.” The Substance offers a rebirth of sorts to its users, with their newer selves literally ripping themselves out of the spine of their originators. Recapturing beauty and youth in the name of self-loathing is a violent act of self-destruction that only escalates the longer it goes on. The grotesque transformations here illustrate a societal unease and manifesting it in the body — when Sue decides she wants more time from Elisabeth, it’s because of Elisabeth’s unwillingness to accept herself. It’s a film that has fun with all its outrageous, chaotic shenanigans, contrasting increasingly insane gore with bright, 1990s-style neon colors that pop across the screen, creating a hyperreal version of L.A. that is easy to get lost in. 

If you’re looking for a subtle meditation on aging and beauty, you’re in the wrong place, but this is a feature, not a bug of the film. The Substance is upfront about women confronting their aging bodies and self-loathing while managing to be a bloody, sharp blast.

Grade: A

This review is from the 2024 Toronto International Film Festival. MUBI will release The Substance theatrically in the U.S. on September 20, 2024.