Coralie Fargeat, director of the female rage vehicle Revenge, returns with a wild, audacious second feature-length film with The Substance. The broad strokes of the premise are as follows: former Hollywood starlet Elisabeth Sparkle (Demi Moore) nears irrelevancy due to her age in an industry that prioritizes being the youngest, sexiest thing around; upon hearing about the mysterious “Substance” drug, which promises to provide “a better version of yourself,” Elisabeth creates a dazzling, skin-tight twenty-something alter ego, Sue (Margaret Qualley).

Whereas the advertising might have you believe that this will be a stately, arthouse take on the obsession with beauty standards, fame, and the desire to reclaim lost youth, Fargeat’s conceit is far loftier – The Substance is a full-blown Cronenbergian hellscape that externalizes the internal violence of being a woman in modern society. It stands to reason that body horror is the perfect means by which to illustrate these everyday struggles of confronting unrealistic expectations of the human body, and the film goes to excruciating, disgusting lengths to enshrine those feelings. The initial transformation sequence of Elisabeth taking The Substance is a tasteful, soon-to-be-skincrawling visual depiction of birthing “you, only better in every way.” But this is only the tip of the iceberg for what the remainder of the film has in store.

Stomach-churning cinematography and an emphasis on tightly-framed shots (specifically of Dennis Quaid‘s utterly despicable hot shot exec) provide a level of discomfort that will have you feeling uneasy far before the picture goes completely off the rails. Nudity plays a central role in the depiction of women throughout, framing Sue’s tight, perfectly supple young body as commodified for male consumption, whereas the sterile, clinical setting of the bathroom presents the naked body in a much more matter-of-fact fashion where the only judgment that remains rests between you and the mirror.

Once the film introduces the specific mechanics in which the titular Substance operates, you could almost hear the gears of the moviegoers turning in real-time as to how it all could go wrong. Those specifics, once in play, ratchet up the displays of violence and maniacal self-affliction that remains at the core of the relationship between Elisabeth and Sue. Sue is in essence societally-abided beauty standards made manifest, and the undertones of eating disorders become overtones as Sue willingly wrests control away from Elisabeth, so that she can not further gorge herself on yet another feast.

Coralie Fargeat has spoken at length about how the film operates as a prismatic dissection of what internalizing other people’s standards for your own body yields, and how that destructive self-hatred can often work its way outward from an inward capacity. Thematically, this feels like a corollary to past works, Reality+ and Revenge, incorporating and exploring the topics of technology, wish fulfillment, physical appearance, the subjugation of the male gaze, and the fallout when aforementioned technology is pushed past its limits.

I say this with confidence:

There is not another film out this year that can offer a more truly unhinged final act. You will likely think to yourself “Okay, surely that must be the end, right? It couldn’t possibly get any crazier from here?” Nope. It only continues to devolve into more and more of an absolute madhouse. With visuals that will be seared into your frontal lobe, and an unexpected penchant for gut-busting laughs, The Substance is a wild sendup of black comedy and bodily gore that will have theaters erupting in its final 30 minutes. You deserve to watch it on the biggest screen possible at the most packed theater you can find.

The Substance is now in theaters, brought to you in part by MUBI.