I am a tall person and I find it difficult to buy large belts. When I bought this strap I had to cut off a couple of inches (very easy to do and they provide visual instructions) and attach a carry case for my tandem diabetic pump. This is the best reversible belt and if your waist is 64 inches you won't find better quality. Oh yes, I wear it 7 days a week, almost non-stop. I liked it so much that I ordered and received a second one.