"Crossing my wrists in Rio has already had a great impact on my life," he said. "I am now separated from my dear mother, my supportive wife and my precious children in Ethiopia who I miss dearly."
With his simple gesture, Lilesa joined a long list of athletes who have used the global sports stage to protest what they describe as injustices in their home countries.
In his case, the crossed wrists symbolized the handcuffs of political prisoners and dissidents in Ethiopia, who he said have been imprisoned for protesting against the taking and selling of land belonging to the Oromo people to foreign investors.
"In November, the government forced farmers off their land and we began to peacefully protest. Since then, human rights organizations say around 500 people are dead. I say that over 1,000 have died; this includes at least 12 people that I know from my home district of Jaldu in Oromia," Lilesa said.
CNN has not been able to independently verify the claim that 1,000 people have been killed since protests began.
Last month, Ethiopia's Communications Minister Getachew Reda described the figure of 1,000 as "nonsense" but he would not offer a figure for the number of protesters who have died. "This game of numbers has no merit," he said at the time.
CNN has tried to contact the Ethiopian government by telephone several times for further comment on these allegations but those attempts have not been successful.
Previously, Reda said Ethiopia's security response to the protests is standard police protocol -- to disperse "rioters." Some protesters have been armed with guns and hand grenades, he said.
As for Lilesa, Reda said he was "entitled to make" a "political statement. That is his right," Reda said. "It's not about holding one political view or another."
Lilesa, who says his family named is correctly spelled as Lelisa but appears differently on his passport and in reporting of his Rio political gesture, spoke of his anguish at what he feared was happening at home.
"Families do not know what happened to their sons and daughters after they were taken by the army and police. We all know someone who has been killed or disappeared," Lilesa told CNN in an email interview.
Olympian fears backlash from government
The marathon runner is now effectively a political exile, estranged from his family and friends and afraid to go back to his country again, despite assurances from the Ethiopian government that he will receive a hero's welcome.
Reda told CNN that Lilesa is an "Ethiopian hero."
"I can assure you nothing is going to happen to his family, nothing is going to happen to him.
However, Lilesa told CNN he did not believe these assurances. "This government says one thing and does something different. I know if I go back to Ethiopia, I will be killed, arrested, or put on a list of people never allowed to leave the country again. The government security has killed hundreds of people for just doing what I did."
After the Olympics, Lilesa stayed on in Brazil for weeks and has now traveled to the US where he has received a special skills visa to train for upcoming races there, he said.
Despite fearing for his safety, Lilesa said he had no regrets following his actions.
"I would have regretted if I had returned to Ethiopia without taking the opportunity to make the situation of my people known in this way and make their voices heard," he said in the email interview from Washington DC.
"My people were yearning to be heard... to let their condition be known and because of my protest... now people know who the Oromo are and what they face," he added.
Runner calls for change in Ethiopia
Lilesa says he has received an outpouring of support since the Olympics.
"People make the sign wherever I go," he said.
A crowd funding site has raised more than $160,000. The site was set up by someone in the US who says he recognized that Lilesa would need support following his anti-government protest.
Lilesa, who has two children in Ethiopia, said he misses his family but added: "I know that the families of all those who are lost and those who are maimed are just as precious. Mine is no different from theirs."
He hopes to one day go back to Ethiopia but, he said, not before things change drastically for those persecuted there.
"We need change in Ethiopia," he said.
"I look forward to a day when all people of Ethiopia can live in peace, with their full rights protected. Like all other people, the people of Ethiopia want justice, free speech, accountable government and a free press."