Why don’t we have any sympathy for beauty addicts?

As Sue (Margaret Qualley) is plunging a needle into an infected wound, consumed by a single-minded pursuit of perfection and unable to stop herself, despite it destroying what’s left of Elisabeth’s (Demi Moore) body and life, it becomes clear she is addicted to chasing beauty and ‘fixing’ her every imagined flaw.

Coralie Fargeat’s satirical body horror film The Substance follows Elisabeth’s journey as she experiments with an unregulated injectable drug that promises to make her a “younger, more beautiful, more perfect” version of herself. As Elisabeth is shoved out, Sue is ushered in, and while, at first, the two uphold the rules, soon the characters’ actions spiral out of control, beginning to exhibit classic signs of substance dependency – experiencing physical withdrawal symptoms, pleading for it to stop, only to relapse at the first opportunity. 

Though the self-harm Elisabeth inflicts is hard to watch, the audience’s callous chuckles were equally difficult to listen to. In her Substack essay on the film, beauty critic Arabelle Sicardi writes how the men next to her “laughed in delight.” Similarly, Mina Le, a fashion and culture YouTuber, argued that “the overall messaging came off as unsympathetic to older women who partake in anti-ageing procedures. My theatre laughed as Demi Moore’s character became more archetypical of a hag, as if the takeaway was that she deserved everything that happened to her in her lust for vanity.”

In a culture that prizes physical appearance as much as ours does, the pursuit of beauty is hard to resist and tricky to condemn. Research has confirmed that ‘pretty privilege’ equates to being thought of as more intelligent, trustworthy and kind. It influences incomes, raises salaries and sways final decisions on promotions. Yet, obtaining something as slippery as beauty remains nearly impossible, due to its inherent subjectivity and rapidly shifting evolution. And now the barriers to entry are higher than ever. Dermal fillers, thread lifts and buccal fat removal are only a fraction of the (expensive, risky) procedures introduced to help people obtain beauty and its promised byproducts: social acceptance and career success.

This can leave people stuck in a perpetual state of chasing an impossible ideal, fighting against the natural ageing of their bodies, and falling into a “perception drift” cycle, where you get addicted to the feeling of ‘glowing up’ and lose sight of what you look like. Dr Jamie Feusner, a professor of psychiatry at the University of Toronto, says there are multiple studies which indicate that around 13 per cent of patients at cosmetic surgery clinics and 11 per cent at dermatology clinics are likely to have Body Dysmorphic Disorder, a mental health condition characterised by an overwhelming preoccupation with perceived flaws in one’s physical appearance.

And yet, while people feel under incredible pressure to achieve impossible, ever-changing standards, and there is an expectation of a certain level of beauty maintenance, when partaking in the beauty industry you are just as likely to get punished as you are rewarded. Take the most recent season of Love Island, for example, during which many of the female contestants were ridiculed for what some viewers saw as ‘overdone and ineffective’ plastic surgery and cosmetic work. Social media was flooded with content mocking the excess, including from medical professionals like Dr Daniel Barrett, who played a ‘guess the contestant’s age’ game. 

“Rather than criticising our culture for making young women believe that they need plastic surgery to fit into today’s unattainable beauty standards, those commenting are more concerned with the fact these women’s procedures are detectable and ‘failed’ to make them look youthful,” as Halima Jibril wrote in her piece on the topic. “The last thing we should do is mock these women.”

And yet time and time again, we see women who have undergone cosmetic work that people deem “unsuccessful” being mocked, punished and even face a form of dehumanisation. Swiss socialite Jocelyn Wildenstein was nicknamed ‘Cat Woman’ for her feline features after numerous facelifts and eye threadings. While the Duchess of Alba, a prominent Spanish aristocrat, was dubbed the ‘Pekingese with Botox’ by the Daily Mail. Both sought to feel beautiful, younger, desirable and accepted – only to be likened to animals, reframed as punchlines in newspapers and stigmatised in everyday conversations.

From a psychologist’s perspective, a “beauty addict" is often defined as someone who undergoes procedures in search of a “high” or a specific reward. Dr Feusner emphasises that these behaviours (especially when repetitive) can be viewed as “compulsive” in a psychiatric context, as they are often performed to alleviate negative emotions of insecurity or self-hatred. However, currently, beauty addiction is generally viewed by the public as a moral failing, the result of being too vain, or too poor to afford a “good” surgeon. As a result, there is a lack of compassion for those afflicted by it. 

In a perfect world, according to Dr Michail Malandrakis, a London-based oculoplastic surgeon and facial aesthetician, the industry would embrace a holistic approach, where the mental health of a patient is considered alongside their requested procedure, where beauty clinics are staffed with both psychologists and facial aestheticians. But we are not yet there. Instead, we lack sympathy, projecting our anxieties and fears around ageing and unattainable beauty standards onto the bodies of women who are simply trying to live by the rules laid out by society. The result, ironically, is that the extreme beauty standards remain unchallenged, while individuals who have tried to attain them (and been told they failed) are left under attack. In the end, no one feels more soothed, and no one feels more beautiful.