This movie is fucking demented.

I mean that in the most enthused, celebratory sense possible. Coralie Fargeat, whose 2017 thriller Revenge was one of its year’s finest features, has finally returned with The Substance. It is a jaw-dropping second film, high in ambition and overflowing with punch-in-the-gut satire. I have one major caveat – that it is about 15 minutes longer than it needs to be – but otherwise for me this is about as good as cinema gets.

Demi Moore plays Elizabeth Sparkle, formerly a very famous Hollywood star now reduced to hosting Jane Fonda-esque exercise programs for television. When she is fired from her position in favour of a younger replacement, Sparkle receives an anonymous offer to sample “the Substance”: an experimental drug regime that promises to restore her youth in an unprecedented fashion.

The best kind of satire is that which can straddle both comedic and serious moments in the same text. Fargeat’s film does exactly that. It portrays female self-destruction at the bidding of patriarchal pressures, and it does so in ways that are dramatic, darkly funny, and regularly quite difficult to watch. It does not take long for Sparkle’s experience on the Substance to emerge as fully-fledged body horror, replete with a surfeit of gore, confronting violence and self-abuse, and flinch-generating medical procedures. I consider myself reasonably comfortable watching extreme cinema, but there are specific moments in The Substance where I simply had to look away from the screen. It is wonderfully provocative stuff.

These sequences, not to mention the deliberately excessive male gaze of the film, reflect its origins in what critic James Quandt called the “new French extremity”. It was a millennial movement within French cinema, led by enfant terrible Gaspar Noé, with a furiously transgressive interest in sex and violence – and particularly the intersection of the two. Fargeat’s first film Revenge was a late-stage entry in that movement, and if it is to continue I think it is second-generation filmmakers like Fargeat and Julia Ducournau (Raw, Titane) who going to drive its evolution. Notably both women have used the movement’s overall conceit to interrogate its predominantly patriarchal origins. They have absolutely left this sub-genre in a better place than when they joined it.

There is precious little restraint to The Substance. Fargeat, with cinematographer Benjamin Kracun, sexualises parts of the film in a manner so deliberately excessive it reminds one of Paul Verhoeven’s Showgirls. In scenes of medical horror, she is relentless in depicting up-close infections, tissues, and fluids. The sound design is truly horrifying: I did not realise watching a wound sewn up would be so much more disturbing when I could hear the thread moving through punctured flesh. Elsewhere Kracun’s clinical shot composition seems inspired by Stanley Kubrick. Everything is grotesque: the sex, the violence, the gore, and the performances.

Demi Moore has been appropriately lauded for her performance here. It is likely a career-best, since it seems so perfectly tailored to her talents. Dennis Quaid is similarly strong, playing the sexist, vulgar television executive Harvey. As the seductive starlet Sue, Margaret Qualley fulfils the great promise she has been expressing in earlier roles. All three lead performances require extremity, and indeed bravery, and it is their fearless portrayals that help to make Fargeat’s satire as finely sharpened as it is.

If only more films were this vivid, shameless, and bold. The Substance excels as comedy, as a thriller, as body horror, and as social commentary. Most importantly it excels as cinema. It is deeply cine-literate, reflecting not just Verhoeven and Kubrick but also Cronenberg, Żuławski, De Palma, Aaronofsky, and many others. It is all held together with a measured hand, and a developing talent that easily surpasses Fargeat’s earlier film.

You may love The Substance. You may hate it. You may very well be actively repulsed by it. You are absolutely not going to forget it.

The Substance is screening at the 2024 Melbourne International Film Festival. Click here for more information.