My waist is 32 so I figured this belt would be big enough. The chart says the 34" is the middle hole but I had to pull it all the way in to fit over the largest hole. I ordered a 36 and it's great. but fits as I expected a 33" to fit.
Pros
The 40 inch size fits a variety of body sizes and is versatile to wear.
Cons
May not be suitable for people with certain medical conditions