* WARNING, This article contains spoilers for the 'The Substance'.

Two things immediately grab the attention of anyone coming to LA for the first time: the towering palm trees and an endless procession of massive billboards. These two visual landmarks are always within sight all throughout the city. Unlike the palm trees, which might at least offer some reprieve from the heat, the gargantuan billboards are a ceaseless showcase of upcoming movies, TV series, and products, instilling in new visitors a peculiar sense of pressure. These are the sights that envelop Elisabeth (Demi Moore), the protagonist in the film The Substance, every day. What sets her apart from visitors to the city is that she’s a famous actress whose image occasionally graces these oversized advertisements around her. Elisabeth is an Academy Award-winning actress, a dream for many in her line of work, and has played host to the fitness program Sparkle Your Life for 30 years. And now, she’s just turned 50.

Right on her birthday, Elisabeth receives the humiliating news that she’s being dropped from her own show, leaving her feeling dejected as she gets behind the wheel, only to then witness her own face on a billboard for a toothpaste ad just as it's being taken down. Reeling from this double blow, she ends up in a car accident. The camera then reveals Elisabeth, clad in a hospital gown, sitting in a devastated daze with her fragile, dry back exposed. On her way out from the hospital, she happens to feel a USB drive in her pocket, along with a note that reads, “It changed my life.” The mysterious USB stick contains a short video about a drug that promises to give birth to “a better version of yourself.” The drug—the Substance that lends its name to the title of the film—allows users to live as this “better version” for seven days at a time, returning to their original self for the next seven, and so on. During the seven-day transformation, the video explains, users only need to inject a stabilizing dose of spinal fluid to have a safe experience living as their “better version.” The video, though shared around on USB rather than the Web, mirrors today’s short-form videos and ASMR clips in its compact, straight-to-the-point delivery. Director Coralie Fargeat subtly suggests that, in an era dominated by video and social media, we’re quicker to be that much more intensely held captive by beauty standards. The video notably glosses over any discomfort or side effects involved in using the Substance, not unlike the way social media or cosmetic surgery apps overplay dramatic physical transformations with before-and-after shots while seldom discussing the long-term repercussions or mental health impact. Most insidious of all, even though it’s really talking about a gruesomely painful process involving the back splitting open to give birth a new self, the video trivializes the risk by using an egg yolk as imagery, totally removing it from the realities of the human body.

While The Substance is also a disturbing take on our appearance-driven culture and ageism, it’s ultimately a body horror film. The scene where Sue (Margaret Qualley), the “better version” of Elisabeth, is born gets to the very essence at the core of the movie. After injecting the Substance, Elisabeth collapses onto the cold bathroom floor, only for a stunning young woman to emerge moments later. As Sue marvels at her reflection, she takes care of the scar left on Elisabeth’s back from her birth and quickly learns how to extract energy from Elisabeth’s body to ensure a successful trade-off. The camera pores over the transformation obsessively. Sue, who resembles but is a “better version” of Elisabeth, becomes a rising Hollywood star after successfully auditioning to take Elisabeth’s place. But it all leaves the audience watching anxiously, unable to shake the sense of foreboding that Sue will break the rules of the Substance laid out in the beginning—and those fears are soon realized. She pushes past the seven-day limit to make time for high-profile events like a Vogue cover shoot. Her relentless desire for public adoration and more time in the spotlight drives her to extract more and more from Elisabeth’s body, stretching the process beyond its limits. Elisabeth’s heartbreaking back, with the scar showing how tightly zipped up she’s had to be for the sake of a better silhouette, continues to fester at the hands of some “better version” of who is, ultimately, herself. The greatest tragedy of the obsession with beauty is that no one torments you more than yourself.

The Substance has been called a horror for women and a comedy for men. Those who approached the film more lightheartedly imagine what a male version would look like, pairing older male actors with younger lookalikes in hypothetical castings on sites like Reddit. They also take the shot of Sue chastising Elisabeth and telling her to “control yourself” when she discovers she’s been binge eating, and repurpose it for memes with captions like, “me when I see my bank balance.” But other reviewers have described The Substance as an agonizing, deeply haunting film. Above all, the prevailing sentiment is one of sadness. It’s no wonder that Korean audiences who perceive this grief see Elisabeth’s obsessive scrutiny of her appearance against the backdrop of Sue’s giant billboards mirroring the reality of having to navigate a subway system lined with advertisements for plastic surgery. It also only makes sense that they voice criticism over the pervasive use of plastic surgery apps given friendly names that include words like “eonni” (“big sister”) or that try to come across as a community for open discussion with words like “talk” in the name.

The Substance emerges from a deeply personal and vulnerable place within director Coralie Fargeat, inevitably leading to a variety of responses from viewers based on their gender or personal experiences. Fargeat confessed at a TIFF (Toronto International Film Festival) Q&A that she “had passed my 40s and I was starting to feel … the pressure of the feeling that I was going to be erased—that I’m going to be disappearing,” and she conveys that apprehension by repeatedly giving variations on variations of it. The darker facets of our appearance-obsessed culture, like self-objectification and incessant self-monitoring, are revisited and intensified throughout, shown through shots of mirrors and door handles. Even when Elisabeth is at her most vulnerable after the accident and runs into an old friend named Fred outside the hospital, he chooses to tell her she’s “still the most beautiful girl in the whole wide world.” Yet before they get dinner together, Elisabeth finds herself scrutinizing her body in the mirror for an extended period. Seeing Sue looming on a billboard through the window, she’s somehow drawn back to the mirror, where she nervously reapplies her makeup and prepares to step outside—only for the door handle to stop her in her tracks. Gazing at her reflection in the metal handle, Elisabeth returns again to the mirror, her hands hovering over her face before she claws at herself and collapses in despair. In the end, she can’t even bring herself to leave, paralyzed in a loop of body-shaming. This kind of catastrophic thinking—mentally escalating worst-case scenarios—is referred to as “awfulizing.” Elisabeth builds up these negative ideas about her appearance and allows them to snowball from there, and in doing so, she generates a deep-seated sense of humiliation that rises up from far down within herself. She finally succumbs to her despair, hunching over in defeat as she confines herself to her bedroom.

Reactions to the film vary, but if there’s one opinion shared among them all, it’s Demi Moore’s outstanding performance. Moore masterfully embodies the unflinchingly honest duality of a character torn between wanting to eliminate the young and beautiful but parasitic “better version” of herself and yearning to hold onto the flame of eternal youth and awe-inspiring beauty. In a scene where Elisabeth opens her eyes to see Sue’s exploitation of her body has left her with hair loss and withered limbs, Moore is flawless as her character decides to put an end to her Substance dependence. At first consumed by fury, Elisabeth flinches at the thought of letting Sue go forever, rocking Sue awake as Moore, in perfect form, displays a mix of tenderness and desperation through soft facial expressions and a gentle voice tinged with anxiety. The conviction in her performance as the withered Elisabeth is astonishing, especially considering the role required her to undergo six to nine hours of special effects makeup, leaving just one or two hours for actual filming. The role earned Moore the Golden Globe Award for Best Actress in a Motion Picture in the Musical or Comedy category—her first Golden Globe win and a significant nod, given her last nomination for a film was for her role in Ghost in 1991.

The Substance is blunt in its confrontation of our image-obsessed culture, but it’s also absolutely alive with the kind of allure cinema does so well, brimming with ambiguous impulses. And the nucleus that makes the film so layered is Moore herself. The film weaves a complex web as it intersects with the real life of Hollywood star Demi Moore. In the 1990s, Moore was the highest-earning actress in Hollywood, but her career saw a decline in the 2000s. Much of the public’s focus was then shifting to the supposition that she was attempting to seem more youthful by appearing alongside her then-partner Ashton Kutcher, 16 years her junior. Rumors swirled about her undergoing a knee lift or spending some $500,000 on a plastic surgery full-body makeover. Though the truth behind such claims remains up for debate, Moore worked all that gossip into her portrayal of the youth-obsessed Elisabeth onscreen, blurring the lines between fiction and reality. When Elisabeth gazes into the mirror, audiences feel as though they’re peering into her soul, but the camera also seems to give them a glimpse at Moore’s own inward-looking thoughts at the same time, creating a hybrid of images where the mirror, Elisabeth, and Demi Moore become inextricably intertwined.

It all seems to come back to the LA landscape. Fargeat’s imagination takes the comment Sue receives during her audition from the casting panel of men—that she’s got “everything in the right place”—and twists it by giving birth not to the “better” Sue but to Monstro Elisasue, a grotesque amalgamation of mismatched facial features and body parts. Adorned with earrings to signal an inability to let go of the desire for beauty, Monstro Elisasue crashes a New Year’s Eve show, but in the ensuing mayhem, both she and Sue vanish, leaving only Elisabeth, staring at palm trees. As the blazing sun sets and darkness falls over the city, the world around her holds at a pleasant temperature. Even with Elisabeth’s Medusa-like imagery symbolizing the longstanding violence against women, she wears an oddly serene expression. Unlike the towering billboards whose seductive illusions serve to obscure their true commercial aim from all who see them, the palm trees stand their ground, true to themselves, their wide leaves waving as time moves forward. It helps to believe that Elisabeth’s radiant smile in the end doesn’t come from having her own star on the Hollywood Walk of Fame sidewalk, but because she ends the whirlwind of events gazing up at palm trees. The fact that the last thing she sees isn’t the billboards that tormented her but a few unassuming palm trees is oddly comforting to an audience that’s just sat in shock and horror all throughout the preceding film.