The Substance review: the grossest movie of 2024 is also one of its best

The opening couple minutes of The Substance are elegantly efficient — words that don’t much leap to mind during the remaining 138 minutes of this outrageous movie. A decade-spanning montage lays out the rise and fall of a Hollywood celebrity entirely through the condition of her star on the Walk of Fame. From an overhead vantage, we watch it cast in concrete and illuminated by flashbulbs. As the years tick off, the camera angle doesn’t change, but its inanimate subject does — degraded by the elements and foot traffic, increasingly ignored by tourists (“She was in that movie,” one manages), this symbol of showbiz immortality eventually symbolizing the opposite. It’s a ruthless little short film on the fickleness of fame, punctuated by a final indignity: a sloppy slice of pizza that lands on the star with a splat.

A lot goes splat in The Substance, the most disgustingly wet movie you’re likely to squirm or hurl through this year. Were this deranged nightmare satire somehow booked in America’s motion-synced gimmick auditoriums — its 4DX or D-Box theaters, where patrons get upcharged for the “pleasure” of getting rocked and spritzed in their seats — the audience would leave as drenched as the front row of a Gallagher show. But there is method to the moistness: In taking her own mallet to bodies and gag reflexes alike, French filmmaker Coralie Fargeat has made a movie as grotesquely flesh- and fluid-obsessed as the industry it savages. Its gore is matched only by its contempt; Sunset Boulevard looks affectionate by comparison.

The Norma Desmond figure here is Elizabeth Sparkle, a one-time starlet played — thanks to a savvy triumph of casting — by real one-time starlet Demi Moore. Now comfortably entrenched in her post-A-list life as the host of a popular TV fitness program, Elizabeth is surrounded by reminders of her advancing years and fading stature, like a peeling billboard with her smiling face on it. On her 50th birthday, she’s unceremoniously canned by her boss (Dennis Quaid, putting the chewing into scenery chewing), who sees no further use for a woman of her age. In case his leering eyes and slurping lips don’t make it clear that we’re seeing the lecherous id of Tinseltown, the fact that he’s named Harvey should do the trick.

Elizabeth’s plummet from hot to not in the estimation of the money men makes her a prime candidate for The Substance, a mysterious and experimental drug that promises all those who sign up a “new you.” If the clean white packaging of injections and applicators suggests Cronenberg by way of Apple, the corresponding instructions are as ominous and rigid as the Gremlins rules. Is Fargeat taking aim at the Ozempic craze or at surgical solutions to the inconvenience of accumulating wrinkles? There’s no direct one-to-one comparison for a mad-science wonder serum that turns Elizabeth into an incubator for the unblemished ingénue (Margaret Qualley) who comes bursting out of her back like a sexy Xenomorph.

Far from yada-yadaing through the physical logistics of the process, Fargeat gives them to us in grisly, granular detail. (Anyone with a needle phobia should prepare for some intense immersion therapy.) The sequence where Elizabeth births Qualley’s “Sue” brings to mind the agonizing, protracted transformation in An American Werewolf in London. In fact, The Substance is a gloriously goopy callback to the whole practical-effects heyday of the 1980s; as its corporeal mishaps escalate, you might think of The Fly or The Thing or the Screaming Mad George flesh-ball insanity of Society. “Gross” does not do justice to this movie’s anatomical perversions. Every ticket sold should come with a commemorative barf bag.

Fargeat is no stranger to stories of extreme bodily trauma. Her first feature, Revenge, was a smart and brutal spin on the rape-revenge thriller; it flipped the predatory, dehumanizing male gaze of its villains, moving their vulnerable raw meat into its crosshairs. With The Substance, the writer-director mirrors a whole town’s objectifying POV back at it. Fargeat’s slickly narcotic, bombastic style — extreme close-ups, hallways bathed in hard primary colors — turns the soulless superficiality of Hollywood into a design principle. Everyone and everything becomes a commodity under the cold, invasive glow of the camera. That includes Sue, a sentient avatar for some part of Elizabeth’s consciousness; Fargeat shoots Qualley like a sports car, lingering on her shining showfloor features.

The film becomes a delirious Grand Guignol farce about two women sharing one life. The hitch of the process is that while Sue is active, Elizabeth is unconscious, and vice versa. They switch off once a week … and if Sue steals extra time, it takes an instant, ghoulish toll on Elizabeth’s physiology. Never mind that it’s much harder to maintain a Nutty Professor double identity when a comatose body has to be hidden and nourished. The truly ingenious complication of the movie is that Elizabeth and Sue have their own motives — and at a certain point, as the latter secures the plum TV gig the former lost, they’re working at cross-purposes. Imagine a version of All About Eve where Margo and Eve are split personalities of the same mind. Just, you know, with more loose teeth and detached fingernails.

You could say The Substance is about body image as a zygote split, cleanly separating an aging star’s distorted sense of self from her pod-person ideal of youth and beauty. It’s Moore who gives the idea some emotional credibility. The Striptease survivor tackles her role with the fearless conviction of a veteran performer intimately familiar with the impossible beauty standards of her vocation, and how opportunities for actresses shrivel over time. Whether staring with self-loathing into her own reflection or screaming with impotent rage under a mountain of increasingly horrifying prosthetics, Moore is the heart of a movie that pumps blood in every direction. She’s certainly the realest thing in a vision of Los Angeles so abstract that Sue’s ratings-dominating workout program is called simply New Show.

The final stretch of The Substance is frankly astonishing in how completely over the top it’s willing to push a demented premise. The climax is so audacious in its torrential downpour of viscera that you might feel the urge to puke and cheer at the same time. There’s not a subtle bone in this movie’s cracking, oozing body. It advertises its themes at great length, high volume, and billboard scale. But maybe there’s no such thing as too broad when you’re tackling the shallowness of the entertainment industry. No depiction of its ugliness could go far enough.

The Substance is now playing in select theaters. For more of A.A. Dowd’s writing, visit his Authory page.