Back in what is sometimes called Hollywood’s Golden Age but might as well be a long-lost prehistoric era given the pace of change over 70 years, Norma Desmond in Sunset Boulevard was a 50-year-old actress consigned to the dustbin of history thanks to an entertainment industry that—at least when it comes to women—values youth.

The more things change… Elizabeth Sparkle (Demi Moore) in the current century finds herself in a similar predicament in Coralie Fargeat’s blackly funny body horror movie The Substance. Only in some ways, Elizabeth has it far worse than Norma—Norma, at least had her faithful manservant Max and, for a little while, her hunky screenwriter gigolo Joe. But Elizabeth spends her 50^th birthday—the moment, her gargoyle of a boss Harvey (Dennis Quaid, earning his money) says everything stops and proves it by firing the one-time star from her job hosting an exercise show—alone in a bar, lining up martinis like little soldiers draining one after another. Home is equally chilly, a chic apartment with a commanding view but little personality other than a huge portrait of the resident’s owner. It’s a lonely lair.

In short, Elizabeth is ripe for the mysterious titular treatment that promises to restore youth. How it accomplishes the feat would lead most people to pass as would the cloak-and-dagger aspects of ordering it from an anonymous voice on the phone and the creepy, dilapidated building where Elizabeth must go to pick up her order. But she is depressed and desperate and only too keenly aware of aging. Offered a “cure” for the simple act of growing older, she jumps at it.

Some panacea. The magical elixir that promises to turn back time can only do so by splitting Elizabeth into two separate and distinct entities in a terrifying, visceral procedure. Sue (Margaret Qualley) emerges, perky and beautiful, as physically perfect as she is empty-headed, charming Harvey into hiring her to replace Elizabeth as fitness maven. The two women are supposed to be one but, in thrall to her new life, Sue gets greedy to her and Elizabeth’s peril.

Moore and Qualley excel in filling out roles that don’t have a lot of, ahem, substance—Fargeat pays precious little attention to either women’s character. Instead, they are types – the one-time star fearful of the onslaught of aging and the recklessly selfish ingenue. In a way, Fargeat is no kinder to women than the industry she’s critiquing. These characters are anorexic—only not in their eating habits.

Also, while there are grisly scenes in The Substance, particularly in the cleaving moment that would do David Cronenberg proud, nothing is so terrifying as Quaid. The comic relief also provides the true grossout moments. Attired in colorful bespoke outfits that make him look like he’s perpetually on his way to some septuagenarian prom, Harvey has the manners of—one hesitates to say “pig,” because that’s insulting to pigs but he’s definitely feral. There is nothing so repugnant and terrifying in the film as the extreme closeups of Harvey talking and eating with his mouth wide open. You have to hand it to Quaid for his utter lack of vanity even as you have to wonder why Fargeat felt the need to one up the actual horror with Quaid’s scenes.

The Substance has hugely entertaining moments, but it’s not exactly original. You can namecheck Cronenberg, David Lynch, Brian De Palma, and more, even John Frankenheimer whose 1966 sci-fi thriller Seconds is this film’s granddad. Like Elizabeth Sparkle, John Randolph’s banker in a panic over growing older, reached out to a mysterious organization for a promised cure. Reborn as Rock Hudson, he discovered there are worse things than sagging skin and wrinkles. Too bad Elizabeth never saw that movie. Might’ve saved herself from a world of hurt. —Pam Grady