LANSING, Mich. -- A former Michigan sports doctor who parlayed his reputation and personal charm into years of sexual abuse of Olympic gymnasts and other young women was sentenced Wednesday following the riveting statements of more than 150 victims. Judge Rosemarie Aquilina sentenced Larry Nassar to 40 to 175 years in prison on the seventh day of a remarkable hearing that has given the girls, young women and their parents a chance to confront Nassar in court.
"I just signed your death warrant," Aquilina said, after saying earlier that Nassar will "be in darkness the rest of his life."
"I find that you don't get it -- that you're a danger. You remain a danger," she said.
Aquilina said it was her "honor and privilege" to sentence Nassar.
"Inaction is an action. Silence is indifference. Justice requires action and a voice -- and that is what has happened here in this court," Aquilina said, before announcing the sentence.
The last witness to speak at Nassar's sentencing hearing was Rachael Denhollander, a Kentucky lawyer and one of the first women to publicly identify herself as one of Nassar's young victims. Denhollander contactedpolice in 2016 after reading reports about how , which trains Olympians, mishandled complaints of sexual misconduct. Nassar worked at Michigan State and also was the national gymnastics squad's doctor.
Denhollander said Nassar groped, fondled and penetrated her with his hands when she was a 15-year-old gymnast in Michigan.
"Larry, I can call what you did evil and wicked because it was," Denhollander said Wednesday.
"You have become a man ruled by selfish and perverted desires," she said.
Prosecutor Angela Povilaitis called Nassar "possibly the most prolific serial child sex abuser in history." She said Wednesday the "breadth and ripple" of Nassar's sexual abuse is "nearly infinite," and that he found competitive gymnastics to be a "perfect place" for his crimes because victims saw him as a "god" in the sport.
"To each survivor: thank you. Thank you for coming forward, for trusting us, for doing what is so hard and difficult," Povilaitis said.
"What is obvious is that a strong group of determined women can in fact change the world -- and will," she said.
"Police and prosecutors must take on hard cases, regardless of who the offender is," she said.
Nassar, 54, also spoke Wednesday, making a brief statement. He said the words of those who have spoken over the last several days have shaken him to his core.
"I will carry your words with me for the rest of my days," he said.
He also said there are no words that describe "the depth and breadth of how sorry I am."
Speaking on CBSN Wednesday following Nassar's sentencing, former U.S. national champion gymnast Mattie Larson -- who testified Tuesday -- said she "felt sick" when she first saw Nassar in court.
She also had a message for abuse victims.
"This whole experience here with all these other women, it's really taught me, and kind of ingrained in me now that it is not your fault," she said.
"If you are a victim of any kind of abuse -- sexual, physical, verbal, emotional -- tell someone immediately. Tell someone who can do something about it," she said.
Nassar had pleaded guilty to assaulting seven people in the Lansing area, including Denhollander, but the sentencing hearing was open to anyone who said they were a victim. His accusers said he would use his ungloved hands to penetrate them, often without explanation, while they were on a table seeking help for various injuries.
The accusers, many of whom were children, said they trusted Nassar to care for them properly, were in denial about what was happening or were afraid to speak up. He sometimes used a sheet or his body to block the view of any parent in the room.
"I'd been told during my entire gymnastics career to not question authority," a former elite gymnast, Isabell Hutchins, said Tuesday.
The judge had been likely to be unsparing in her treatment of Nassar. Aquilina has praised the victims who have appeared in her court since Jan. 16, calling them "sister survivors," while also assuring them that their perpetrator will pay. The women have included Olympians Aly Raisman, Jordyn Wieber and McKayla Maroney.
"Your words are vital. They are as strong as your martial arts," Aquilina told Christina Barba, who has known Nassar for decades and practices karate. "They will take him down quicker and cleaner than any kick you've got."
Hutchins and Mattie Larson talked about how Nassar won their allegiance with candy, Olympic trinkets and encouraging words while they were under constant scrutiny from their demanding coaches.
Brooke Hylek, a gymnast who plans to compete in college, heaped scorn on Nassar.
"I cannot believe I ever trusted you and I will never forgive you," she said Tuesday. "I'm happy you will be spending the rest of your life in prison. Enjoy hell by the way."
Emily Morales had a softer message.
"I want you to apologize to me right here," the 18-year-old told Nassar. "I want to forgive you, but I also want to hear you tell me that you regret all the hurting you caused."
He did. She replied with, "Thank you."
Three women alleging abuse spoke with "" early last year, describing what they say was an emotionally abusive environment at the national team training camps at the Texas ranch run by coaches Bela and Martha Karolyi. They said the circumstances provided Nassar an opportunity to take advantage of them and made them afraid to speak up about physical or emotional pain.
"He would put his fingers inside of me and move my leg around," Jamie Dantzscher, one of the women, told Dr. Jon LaPook on "60 Minutes." "He would tell me I was going to feel a pop. And that that would put my hips back and help my back pain."
An osteopathic physician, Nassar was one of the most renowned doctors in the world of gymnastics. As a trainer or physician, he worked with Olympic and National Women's artistic gymnastic teams for more than two decades. He was usually on hand at the Karolyi ranch when the national team was training there, roughly once a month, and also present at national team competitions.
The CEO of the U.S. Olympic Committee announced an independent investigation Wednesday intended to determine how the sexual abuse attributed to Nassar could have gone on as long as it did. Scott Blackmun said the third-party investigation will attempt to determine "who knew what and when" when it comes to Nassar.
Blackmun praised the recent resignations of three USA Gymnastics board members, but said all current directors in the organization must also step down. Blackmun said the U.S. Olympic Committee is "incredibly sorry" and did not ensure that the girls and young women were not given a safe opportunity to pursue their dreams.
Last week, Michigan Attorney General Bill Schuette accepted Michigan State's request to investigate how the school handled complaints about Nassar. Michigan State said a "review is needed to answer questions that persist." Many victims say they reported Nassar's abuse to various members of university staff. Michigan State said campus police got its first report in 2014. The Ingham County prosecutor declined to file charges.
Nassar had already beenin federal prison for child pornography crimes. He is scheduled to be sentenced next week on more assault convictions in Eaton County, Michigan.