The product is designed and built really well. In fact I think I may be buying one for a family member. The reason I am giving it 4 stars is that it is a bit harder to remove than traditional belts. In addition, it is also harder to return it to the optimal position (ie it may be too tigthen or too lose) if you go to the restroom, undo it, and then try to put it back the way it was. A possible solution to this last issue would be to have dots of a different colors spaced about an inch in the inner surface of the belt. This would help the client remember where it feels more comfortable. This is important whenever you are in a rush and do not have time to feel where you feel comfortable.