Apparent illness has Sarno slimmed down to "under 200 pounds" according to his attorney, after tipping the scale at 350 or more according to estimates over the mob's more gluttonous years.
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These days Sarno hardly lives up to his nickname "the Large Guy" and certainly doesn't fit the mob moniker he began with as a budding gangster: "Fat Boy."
Also, the career hoodlum is promising to eschew an Outfit life he enjoyed for decades if he is let out of prison early on "compassionate release," his attorney pledged during a court hearing.
RELATED: Chicago Outfit VIP Mike 'The Large Guy' Sarno wants COVID-19 prison break
Sarno, 63, became a "made man" -- or wiseguy as Hollywood likes to refer to official blood-oath inductees to the crime syndicate -- years ago, according to mobologists.
As the I-Team first reported in September, Sarno was denied compassion release on COVID-19 grounds even though his attorney John Chwarzynski made a case that the mobster's health was in such a free-fall that that contracting coronavirus behind bars would be tantamount to a death sentence.
During Wednesday's virtual court hearing on a renewed motion for release, the COVID get-out-of-jail card was taken off the table when it was revealed that Sarno recently had the second of two vaccine shots at the U.S. Medical Center for Federal Prisoners in Springfield, Missouri where he is now housed. Sarno continues to suffer from a long list of maladies from head to toe. He is "severely deteriorating," Chwarzynski told the judge on Wednesday.
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"He's not receiving proper care. He's not receiving proper treatment," the attorney said in arguing for his client's early release.
RELATED: Federal prisons plagued by COVID-19 infections as plans for vaccine distribution develop
In 2008, the feds busted Sarno's for operating Outfit gambling businesses and a robbery crew that was in cahoots with the Outlaws biker gang. The federal case also involved a firebomb attack on a Berwyn competitor and all of it landed Sarno a 25-year sentence.
"He wasn't given a death sentence" Chwarzynski told Judge Ronald A. Guzman, who sounded stubbornly unconvinced during the hearing to determine whether compassion was in order for Sarno.
The "sentence was one your client earned," Judge Guzman said. He expressed concern that if released, in failing health and unable to pay for expensive private nursing care, Sarno "out of desperation will return to crime" and resume calling shots for the Outfit from a wheelchair.
The government contends Sarno deserves no compassionate consideration, should serve out his sentence as imposed, and that the prison medical facility in Springfield where he resides is designed for inmates in his condition. The long-term medical treatment is "adequate care" for Sarno, according to Assistant U.S. Attorney Amarjeet S. Bhachu. Additional court hearings on the matter are scheduled for March and April.