Let’s get one thing clear: I am a pretty squeamish person. Because of that, body horror is not really my genre. (I’m more of a psychological horror kind of gal.) So needless to say, Coralie Fargeat’s The Substance proved a challenging watch for me. But I’ve never been happier to gasp, cringe, and peek through my fingers during a movie. The Substance is easily one of the best films of the year.

Fargeat, who wrote and directed the feature, presents an incisive portrait of youth, beauty, and fame, all wrapped up in a darkly comedic and increasingly horrific story. The Substance follows Demi Moore as Elisabeth Sparkle, a celebrity whose decades-long career as an actor and fitness icon seems to be coming to an abrupt — and in Elisabeth’s mind — unjustified end. When the network fires Elisabeth from her long-running workout TV series with the intention to replace her with someone younger, she resolves to take drastic action. 

Enter “the substance,” a sort of black market injection that ultimately allows Elisabeth to rip a younger version of herself out of her own body. Now she can literally reclaim her youth — and her TV show, and the love of her adoring fans — for one week at a time. Because that’s the deal: for the arrangement to work, Elisabeth must spend one week as herself for every week she spends as “Sue” (Margaret Qualley). And when Sue starts to play fast and loose with this one rule, the consequences for Elisabeth prove dire.

As I mentioned before, The Substance is not for the faint of heart. The film offers up such a wide-ranging, comprehensive list of squirm-inducing, skin-crawling moments. If there’s something out there that makes you cringe, it’s probably in The Substance. Do you hate the sound of gross, sloppy, noisy eating? Pulling out teeth or pulling off fingernails? What about eyeballs splitting and multiplying into more eyeballs, or a spine cracking open like an egg before getting stitched back together, Frankenstein-style? God forbid you (like me) hate needles, because I’ve never seen so many in one film. And I haven’t even talked about tissue decay, cracking bones, or Monstro yet. But no — that’s best left as a surprise.

Even beyond the spectacle of its onslaught of body horror and general cringe-inducing sounds and visuals, The Substance entertains from start to finish. The film perfectly cuts through its horror elements with moments of dark comedy, breaking the tension to ratchet it back up again. It’s not a subtle film — in its horror, its comedy, or its societal commentary — but I believe it’s all the better for taking things to the extreme. However, the campier aspects probably won’t hit for everyone.

Anchoring this bizarre world is some truly unforgettable acting by Moore. It’s the kind of performance you’d call “career-making,” if the actor in question wasn’t, you know, already Demi Moore. The Substance demands a lot from its star, but Moore rises to every challenge. One moment she’s Elisabeth Sparkle, fitness guru superstar. The next, she’s flying off the handle, full of manic, vindictive energy as she skewers Sue’s latest actions. In yet another, she’s heart wrenchingly vulnerable, trying to get ready and unable to look at herself in a mirror. Moore handles every emotional, comedic, and horrifying beat with aplomb.

Ultimately, The Substance draws you in at every turn. You’ll think things can’t escalate any more and then somehow, they do. When you think the story’s over, it instead careens into an even more bizarre and grotesque final act. This is undeniably one to watch with a crowd. The experience of gasping out loud, laughing, cringing, and squirming in your seat surrounded by others doing the same is simply unmatched.

The Substance premieres in theaters September 20.