The sentence capped a remarkable seven-day hearing in which scores of Larry Nassar's victims were able to confront him face to face in a Michigan courtroom.
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Judge Rosemarie Aquilina said Nassar's "decision to assault was precise, calculated, manipulative, devious, despicable."
WATCH: Judge's full statement
Raw video: Judge's full statement in sentencing of Dr. Larry Nassar
"It is my honor and privilege to sentence you. You do not deserve to walk outside a prison ever again. You have done nothing to control those urges and anywhere you walk, destruction will occur to those most vulnerable."
WATCH: Aly Raisman delivers victim impact statement at trial for Larry Nassar
Aly Raisman delivers victim impact statement and much more at trial for Larry Nassar
Nassar found competitive gymnastics to be a "perfect place" for his crimes because victims saw him as a "god" in the sport, a prosecutor said Wednesday, shortly before the former doctor was to be sentenced for years of molesting Olympic gymnasts and other young women.
"It takes some kind of sick perversion to not only assault a child but to do so with her parent in the room," prosecutor Angela Povilaitis said. "To do so while a lineup of eager young gymnasts waited."
She described the "breadth and ripple" of Nassar's sexual abuse as "nearly infinite."
"What does it say about our society that victims of sexual abuse have to hide their pain for years when they did nothing wrong? What does it say about our society when victims do come forward ... and are treated as liars until proven true?" Povilaitis said.
Watch impact statements from victims of Dr. Larry Nassar
Nassar turned to the courtroom gallery to make a brief statement, saying that the accounts of more than 150 victims had "shaken me to my core." He said "no words" can describe how sorry he is for his crimes.
"I will carry your words with me for the rest of my days" he said as many of his accusers wept.
WATCH: Nassar's full statement
Raw video: Dr. Larry Nassar gives statement during sentencing
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One of the first athletes to accuse Nassar of sexual assault was the last victim to offer statements at his sentencing hearing.
Rachael Denhollander is a Kentucky lawyer who stepped forward in 2016 after the sports' governing body was accused of mishandling complaints of sexual assault. She said Nassar groped, fondled and penetrated her with his hands when she was a 15-year-old gymnast in Michigan.
Denhollander's statements to Michigan State University police put the criminal investigation in high gear in 2016.
"You have become a man ruled by selfish and perverted desires," she told Nassar, who worked at the university and USA Gymnastics, the governing body that also trains Olympians.
Nassar, 54, pleaded guilty to assaulting seven people in the Lansing area, but the sentencing hearing has been 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 is 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."
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Hutchins and Mattie Larson, a former national gymnast, talked about how Nassar won their allegiance with candy, Olympic trinkets and encouraging words while they were under constant scrutiny from 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."
Nassar has already been sentenced to 60 years in federal prison for child pornography crimes. He is scheduled to be sentenced next week on more assault convictions in Eaton County, Michigan.
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