NEW YORK • For 20 years, Ms Alicia Machado has lived with the agony of what Republican presidential nominee Donald Trump did to her after she won the Miss Universe title: shame her, over and over, for gaining weight.
Private scolding was apparently insufficient. Mr Trump, then an executive producer of the pageant, insisted on accompanying the teenage Ms Machado to a gym where dozens of reporters and cameramen watched as she exercised.
Mr Trump, in his trademark suit and tie, posed for photographs beside her as she burned calories in front of the media. "This is somebody who likes to eat," he said from inside the gym.
Miss Universe 1996, who grew up in Venezuela, said she had eating disorders and psychological trauma as a result of the episode.
"I was sick - anorexia and bulimia for five years," she said in an interview with The New York Times in May. "I was 18. My personality wasn't created yet. I was just a girl."
Mr Trump has acknowledged pressuring her to lose weight, saying it was her job as Miss Universe to remain in peak physical shape.
On Monday night, Democratic presidential nominee Hillary Clinton turned Ms Machado's pain into a potent political weapon on the biggest possible stage.
During their 90-minute debate, Mrs Clinton seized on Mr Trump's conduct, and at the end of the face- off, she reminded viewers of Mr Trump's frequently crude remarks about women and their bodies.
"One of the worst things he said was about a woman in a beauty contest. He loves beauty contests, supporting them and hanging around them," Mrs Clinton said, as she slowly unfurled the story. "And he called this woman 'Miss Piggy'... he called her 'Miss Housekeeping', because she was Latina."
Mrs Clinton paused. "Donald, she has a name: Her name is Alicia Machado. She has become a US citizen, and you can bet she's going to vote this November."
On Tuesday morning, Mr Trump made no apologies for his conduct with Ms Machado. "She gained a massive amount of weight and it was a real problem," the Republican nominee told Fox News.
"Not only that, her attitude, and we had a real problem with her, so Hillary went back into the years and she found this girl - this was many years ago. And found the girl and talked about her like she was Mother Teresa. And it wasn't quite that way but that's okay. Hillary has to do what she has to do."
In an interview with CNN's Anderson Cooper on AC360 on Tuesday, Ms Machado was asked about reports of an incident in which she was accused of driving a getaway car from a murder scene soon after the Miss Universe pageant. "There are reports that Trump surrogates tonight have been referencing and been pointing to... about an incident in 1998 in Venezuela where you were accused of driving a getaway car from a murder scene. You were never charged with this. The judge in the case also said you threatened to kill him after he indicted your boyfriend for the attempted murder. I just want to give you a chance to respond these reports," Mr Cooper said.
Ms Machado, 39, responded: "He can say whatever he wants to say. I don't care. You know, I have my past, of course everybody has a past. And I'm no saint girl. But that is not the point now... (Trump) was really rude with me, he tried to destroy my self-esteem. And now I'm a voice in the Latin community. I'm in a great moment in my life and I have a very clear life. And I can show my taxes."
