Trump, who owned the Miss Universe pageant until last year, ridiculed Machado’s weight and verbally abused her following her 1996 victory. Machado’s story got renewed attention during Monday’s presidential debate, when Democratic nominee Hillary Clinton used it to highlight Trump’s history of misogyny. 

“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. And he called this woman ‘Miss Piggy.’ Then he called her ‘Miss Housekeeping’ because she was Latina,” Clinton said. “Donald, she has a name. Her name is Alicia Machado, and she has become a U.S. citizen and you can bet she’s going to vote this November.”

Clinton’s campaign reinforced the point after the debate, releasing a video featuring Trump’s comments about Machado.

Trump, who has admitted that he told Machado to lose weight, would not back down. He told Fox News on Tuesday morning that at the time, Machado had “gained a massive amount of weight, and it was a real problem.”

After Machado’s Miss Universe victory, Trump forced her to diet and exercise. During one workout, he ambushed her with TV cameras. In addition to body-shaming Machado, Trump spoke derisively of her Latina heritage, criticizing her accent and calling her “Miss Housekeeping.” 

Machado has said Trump’s public shaming of her had a lasting impact on her health, including eating disorders and depression.

“I was in some gym in New York like a mouse,” Machado told The Guardian, reflecting on the ambush. “’Look at that mouse: how she run, how she jump, how she make exercise.’ Like that. In that moment is when … problems come to me and start.”