The medium is actually quite large. So if you don't have a size 20 pant, you can probably get a medium size. I took it into the sea as an extra precaution. I was able to leave most of my body behind so I could easily get back on the paddleboard if needed. I fell a few times and felt the belt pull me back up to the surface. It definitely does its job and is a lot more handy than a full life jacket when I'm paddling.
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