The Substance and Suffering to be Beautiful

Still feel queasy. Still wrote a think piece.

When I started telling people about The Body Image Archives recently, almost everyone asked me whether I’d watched The Substance. I can now say that I have and…holy shit.

I used to be one of those try-hard, too cool teenagers who’d watch Saw and laugh (a lot to unpack there, I know). So when people told me it was disgusting and reviews referred to it as a body horror, I took that as a challenge.

It’s hard to know where to begin. I’ve thought about this piece ever since I started scribbling wildly in my notebook on the way home from the screening because it felt wrong to do my usual going home routine (listening to an eclectic mix of Megan Thee Stallion and Deftones while zoning out on the tube) after witnessing such a horror-show.

Maybe I could begin at the end, when I was leaving the cinema. It was one of those films where I felt the effects of the cinematography wearing off as I was popping to the bathroom; every noise and light felt exaggerated, my eyes became the hyper-focused and intense camera lens. In what felt a bit too on the nose, I walked into a white tiled bathroom with stark lighting, which, if you haven’t seen The Substance, is where some of the most gruesome moments of the film take place. What was also fitting was that I left the cubicle at the same time as a glamorous middle aged woman. We noticed each other in our peripheral vision as we looked intently at ourselves in the mirror, our gazes having more deliberate intention than perhaps they would have before the film.

She broke the silence.

“Did you just see…”

I took a sharp intake of breath and scrambled.

“Yes! I hate that I’m in a white tiled bathroom right now! It was just so…eugh? Ugh! UGHH?!”

I kept finding myself stopping and starting my sentences with her because I was still struggling to put how I felt into words. She told me that watching the film reminded her of the same fear and discomfort she felt when she watched Eraserhead as a child, knowing she was too young to be watching it. As I left the bathroom, I said that I hoped that she would be able to sleep that night and I went on my still dazed, not-so-merry way.

This film was so in keeping with The Body Image Archives. Elisabeth, Demi Moore’s character, is imbued with self loathing, which ends up being affirmed to her by her vile, misogynistic boss (played by Dennis Quaid) when she overhears him in the bathroom talking about how she must be replaced by someone younger and hotter. In order to meet said standards, she takes The Substance, a black market concoction recommended to her, which creates a younger version of herself (played by Margaret Qualley) so that she can be who the world wants her to be. Unfortunately, taking this Substance has dire consequences.

What ensues in this film is her battle with how much she hates herself, and what she is willing to do in order to remain beautiful in the eyes of men, and by extension, society. The Body Image Archives seeks to chronicle the media that has informed how we feel about our body image, so that we can make how Elisabeth felt in the film (and how many of us already feel) a thing of the past.

Watching this weirdly reminded me of my own ‘origin story’. In the field I’m in, I’m often asked about my own body image journey, how I came to be in the body image space, and what radicalised me into wanting better for our collective body image.

Like Elisabeth (and again, so many of us), I received a great deal of pressure to make myself smaller and become more in keeping with what was collectively understood as beautiful from the world around me, but also from men. The main story I used to tell when asked about how I got here was of my first relationship. Well, I say relationship, however this man (I was 14, he was 17) told me that as long as I was the size that I was (a UK size 12), we would never be together, because I was ‘too big’ for him. My first kiss ever, with him, took place in the middle of the woods because, as I found out later, he didn’t want to be seen with me in public. This exacerbated my own already terrible body image issues, and what followed was years of me engaging in disordered eating, normalising my stomach hurting from not eating all day, in the hope that one day, I would be good enough, deemed worthy enough, to be seen in public with him and be claimed by him. He would tell me he loved me in one breath, then tell me how much he hated how ‘big’ my body was in the next.

One day, he found a photo of my friend and I. Said friend happened to be deep in the throes of her struggle with anorexia. He cut me out of the photo, sent it back to me, and lamented about how much he wished I looked like her. Even when I was finally rid of him, I didn’t shake off my disordered eating habit and self hatred for years to come. The feeling that my body was not good enough had already seeped into my bones.

When I tell this story, I am always met with the same reactions - disgust, horror and sadness that anyone could treat me like this. And they’re right. No one deserves to be treated the way that I was. Elisabeth didn’t deserve to be thrown to the curb when she turned 50. Like Elisabeth’s story in The Substance and my story, we were victims of beauty standards that both ourselves and the men around us had internalised. We both experienced men being the gatekeepers of worth and beauty, that we were not enough the way that we were, because they have learned that beauty and attractiveness looks a certain way. We, in turn, internalise that same message that we are unworthy and disposable until we become what is expected of us. We both went to agonising lengths to become what society wanted us to be, putting ourselves through pain, hurt and trauma to be deemed desirable. Because after all, we had both learned that if you’re not enough, you must change, or you will be discarded.

Of course, what Elisabeth ends up putting herself through by taking The Substance is a great deal more gruesome and graphic than what I did. However, when you look at the extent to which we seek out beauty and what we put our bodies through to fit into beauty standards, there is this undercurrent of normalised pain and sometimes, gore.

Upon leaving the cinema, I still felt queasy after having witnessed the pain Elisabeth put herself through. It also made me think about all the women who have put themselves through varying degrees of pain for similar reasons as Elisabeth; all the women who have had cosmetic procedures and have suffered life-altering consequences, or have died, so that they could feel better about themselves, and feel more beautiful. At the time of writing, we have most recently lost Alice Webb, mother of five, who has died from complications from a liquid Brazilian Butt Lift procedure. Donda West, Kanye West’s mother, died as a result of ‘multiple post-operative factors’ following a tummy tuck, liposuction and a breast reduction. As a result, Donda’s Law was created, which is a law which requires patients to have physical exams before undergoing surgery. Kanye himself paid for the procedures, so one could say it would have been some of the best surgery money could buy. All the cases I have come across are so deeply heartbreaking.

Not long ago, I remember someone commenting on one of my posts essentially saying that body image issues just ‘aren’t that deep’. If we’re dying in order to fit into beauty standards, then it really is that deep.

Closer to home, a few years ago I discovered that I had a condition called Tubular Breast Syndrome by accidentally stumbling upon resources about it on plastic surgery websites. After years of knowing that my boobs were different but not understanding why, I finally saw a chest like mine represented - but only as the ‘before’ in before and after photos from plastic surgeons advertising breast augmentations. Each website told me that my chest was something that needed to be fixed, unfortunately affirming to me the idea that I already had in my head that there was something wrong with me, that I wasn’t good enough as I was.

In response, I launched my Tubular Breast Syndrome awareness campaign, #TotallyTubular🤙, in 2021 to raise awareness and break the taboo around the condition, to show others that their breast difference was nothing to be ashamed of. What makes us different is what makes us beautiful. Ever since then, I have received a multitude of messages from people all over the world from people who struggle to accept their chest, who’ve accidentally found out about it just like I did. For some, they found out too late. By the time they had reached out to me, some had already had breast augmentation surgery and had experienced Breast Implant Illness and had to get their implants removed. A spoiler for the film: the Substance proves lethal: just as these procedures could be.

A common theme through so many of these messages is the struggle to feel beautiful and desirable because the messaging around TBS is so harmful. No wonder so many felt that they needed to go under the knife, when most google results about Tubular Breast Syndrome tell you that you’ll only be beautiful if you undergo the surgery to ‘fix’ your chest. People with Tubular Breast Syndrome deserve better than this. We all do.

I grew up in the early noughties, during a time where makeover shows were at their peak, and many of them had plastic surgery at the crux of them. Extreme Makeover and The Swan were particularly popular shows at the time where people - usually women - put themselves through multiple surgeries so that they can look the way they’ve always dreamed of, and by doing so, transform their lives. Looking back on this, it was such a wild time for television. I was a preteen/early teenager watching peoples’ skin be cut, opened up, shifted, and not once did I bat an eyelid. One article from Slate said of Extreme Makeover in particular, “there is, perhaps, no more violent show on television”.

This normalised violence was framed as the cure to the contestant’s self esteem problems. Not progressing at work? Get your teeth fixed. Not feeling good about yourself? Don’t worry about going to therapy and working through your self esteem issues, a tummy tuck and breast augmentation will fix that right up. And of course people would feel this way - the media at the time loved to critique normal looking bodies (Heat Magazine’s Circle of Shame, anyone?) and praise celebrities that had lost weight and undergone makeovers of their own. So inevitably, the narrative created was that changing your body, no matter how painful, was the key to happiness, success and being celebrated. And when there are whole generations who grew up on this rhetoric, inevitably that was going to be internalised by so many of us.

So when I watched The Substance, I was unsurprised. Of course Elisabeth was going to take something she didn’t necessarily know the risks of in order to become thinner, more toned, younger, and therefore beautiful, because we live in a world that encourages it and promises happiness and acceptance on the other side of it all. Whether it’s gym culture’s insistence that ‘pain is gain’ or the phrase ‘il faut souffrir pour être belle’, which translated means ‘one must suffer to be beautiful’ from 1800s France which has permeated throughout beauty culture, many of us learned that to be beautiful, you must expect to go through some kind of pain. And even though beauty standards are arbitrary, and we know this in theory, we feel the pressures to fit into them so, so deeply.

This is not to judge those who go under the knife. As I spoke about in my previous post about Ozempic, seeking such dramatic lengths to change your body in an openly fatphobic world is symptomatic of the context we exist within. We exist in a culture that shoves its definition of beauty down our throats and demands that we fit into this dictated mould. For many people, not fitting into said standard can be the difference between being respected, being given rights, being given access to care and resources - for example, fat trans people can be rejected from gender affirming surgery due to their BMI.

If we want to mend our collective body image, we must go beyond the symptoms we are feeling in response to this bad body image mess, and get to the root causes. We must critique the systems that encourage normalised pain for beauty, that make people feel like they need to do all this in the first place.

And how can we resist this expectation? I’ll be exploring this throughout my work, my research, and on this Substack. Because we clearly need more positive resources if so many of us struggle with how we look and how we feel about ourselves.

You do not need to suffer to be beautiful. You are already enough.