<p>You really shouldn’t have that much trouble around the waist. Most off the rack suits come as small as 36, which is designed for a 30" waist. If you go smaller than a 30" waist, it sounds bad, but you can shop in the boys department and find suits with waist sizes in the 20’s.</p>
<p>The problem you might have is a big chest with small waist - say a 42" chest with a 32" waist. If that’s the issue (I wouldn’t exactly call it a problem), most designers have athletic cut suits designed for big chest/small waist guys. The coats taper in around the waist.</p>
<p>In a worst case scenario, you can buy suit separates to get something that fits you. The waist of a coat can be brought in a lot, so find a pair of pants that fit and a coat that fits around the chest, then have the waist of the coat brought in.</p>