Alicia Machado speaks at a news conference to mark the one-year anniversary of Donald Trump’s presidential campaign on June 15 in Arlington, Va. (Astrid Riecken/For The Washington Post)

Donald Trump’s decision to attack a former Miss Universe for gaining too much weight thrust the Venezuelan-born actress into the middle of the presidential campaign on Tuesday — an outcome that was welcomed and encouraged by his Democratic rival, Hillary Clinton.

Alicia Machado alleges that Trump called her names such as “Miss Piggy” and “Miss Housekeeping” because she gained weight after winning the Miss Universe crown in 1996, when Trump owned the pageant. Clinton brought up Machado’s case during Monday’s first presidential debate, prompting a furious response from Trump that night and into Tuesday next morning.

“She was the worst we ever had. The worst. The absolute worst. She was impossible,” Trump said of Machado in an interview on Fox News Channel Tuesday. “. . . She was the winner, and she gained a massive amount of weight, and it was a real problem. We had a real problem.”

Trump’s broadside was aimed at a bilingual Latina immigrant who recently became a U.S. citizen — representing two key categories of voters Clinton needs to turn out to vote.

Machado has been working closely with the Clinton campaign since the summer, and she and the Democratic nominee were clearly prepared for Trump’s reaction. The campaign released a two-minute Web video telling Machado’s story after the debate, while Cosmopolitan magazine published a profile of Machado on Tuesday that included photos of her draped in an American flag.

At the Sept. 26 presidential debate, Hillary Clinton knocked Donald Trump for his treatment of former Miss Universe Alicia Machado. Here's what you need to know about Machado. (Monica Akhtar/The Washington Post)

Machado said in a conference call arranged by the campaign that the fresh attacks by Trump were “a bad dream.”

“I’m going to be with Mrs. Clinton until the end, whatever she needs from me, with pleasure, I’m here for her,” she said.

Trump’s decision to attack Machado so personally is similar to how he confronted Khizr and Ghazala Khan, the Pakistani-born parents of a U.S. Army soldier killed in the Iraq War, and Gonzalo Curiel, a Mexican American federal judge overseeing legal challenges to the candidate’s now-defunct private university. He also recently went after an African American pastor in Flint, Mich., who had asked him not make a political speech while appearing at her church.

On Tuesday, House Speaker Paul D. Ryan (R-Wis.) demurred when asked by reporters about Trump’s comments on Machado.

“I was working out and working this morning, I didn’t watch,” Ryan said. “I wasn’t watching Fox News this morning. So I’m not going to comment on something I didn’t see.”

Machado was tabloid fodder in the late 1990s, when supermarket magazines and syndicated entertainment shows documented her on-again, off-again feud with Trump over her weight. Once her reign ended, she launched a successful acting career, and more recently has emerged as a political activist.

This video produced by the Clinton campaign features Alicia Machado, a former Miss Universe who accused Donald Trump of being verbally abusive, calling her "Miss Piggy" and "Miss Housekeeping." (Hillary Clinton)

Clinton cited Trump’s treatment of Machado in the closing minutes of debate as a way of amplifying other unflattering comments Trump has made about women.

“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,” Clinton said.

“He called this woman ‘Miss Piggy.’ Then he called her ‘Miss Housekeeping,’ because she was Latina.”

Furious, Trump interrupted her.

“Where did you find this? Where did you find this?” he asked.

Clinton continued: “She has become a U.S. citizen, and you can bet she’s going to vote this November.”

Shortly afterward, the Clinton campaign posted a video featuring Machado speaking in Spanish about how Trump called her “fat” and “ugly.” The video featured file footage of a televised workout session that Trump ordered Machado to attend in order to keep her crown. “So this is someone who likes to eat,” Trump said in the recording.

Speaking with reporters on Tuesday, Machado recounted how Trump “always treated me like a lesser thing, like garbage.” She said in a mix of Spanish and halting English that she watched the debate with her mother and daughter and cried as Clinton recounted her story.

She said she has not spoken with Trump since 1997 “and I don’t want to see him anymore, either.”

“For me, this election is like a bad dream,” Machado said. “I never thought, and I never imagined that 20 years later I would be in this position. That I would be in this moment, watching this guy doing stupid things, [making] stupid comments.”

Priorities USA, a super PAC spending tens of millions of dollars on television ads in battleground states, released a new digital ad on Tuesday highlighting Trump’s comments about Machado and other women and said it might end up in forthcoming TV ads.

“Donald Trump consistently attacking women for the way they look, and nicknaming [Machado] ‘Miss Housekeeping’ simply because of her race is emblematic of why he’s struggling so badly with women and will continue to do so for the rest of the election,” said Priorities USA spokesman Justin Barasky.

Maria Cardona, a Democratic political consultant and Clinton supporter, cast Machado’s emergence as “brilliant” and well-timed, given that it came on National Voter Registration Day, which Democrats used to encourage Latinos and younger voters to sign up to vote and at a time when Clinton is hoping to improve her favorability rating among voters.

“Anybody who has ever had a daughter, a mother, a sister who has struggled with weight, who has struggled with self-perception, with self-doubt, and women themselves who go through that every single day are going to be able to relate to this story,” Cardona said.

Machado hails from an influential and politically engaged extended Venezuelan family and left college to compete for the Miss Universe crown and pursue what she hoped would blossom into a career in the U.S. entertainment industry. Trump purchased the Miss Universe pageant just in time to become her boss. When she won, all Machado knew was that Trump had big plans to boost the pageant’s profile and profits.

In the end, she came to view Trump as an insensitive bigot and misogynist who seemed to view the pageant and pageant contestants alike as his personal property, Machado recounted in an interview earlier this year for a Washington Post biography, “Trump Revealed.”

“I cannot believe that piece of sh-- could possibly be president,” Machado said in the interview, adding later that Trump “behaved like a tyrant when I was Miss Universe and has behaved like a potential despot during this campaign. He lacks the basic skills to govern and is not a good human being.”

Over the course of the year that Machado held the Miss Universe title — and, as Trump often reminded her, worked for him — she would feel intense pressure to shed the pounds that Trump told many television reporters, viewers and magazine readers that Machado had gained.

In a 1997 interview with radio host Howard Stern — unearthed by BuzzFeed News on Tuesday — Trump called Machado an “eating machine” and said “she ate a lot of everything.”

He boasted later how he had turned Machado’s weight loss into public scene. “It has become a major event,” he said.

Trump was convinced at the time that Machado’s weight gain was a violation of her contract. It even prompted officials with the Miss Venezuela pageant system to comment on her weight to the English- and Spanish-language media.

It was never clear how much weight Machado had actually gained in the first place, with Trump claiming she had gained 50 pounds or more depending on the interview.

But in a 1997 Washington Post interview, Machado called those numbers “ridiculous,” saying she gained 19 pounds at most and had lost most of it again.

“When I was preparing for Miss Universe, it was an obsession for me to not gain weight,” she told the Post then. “By the time I won, I was actually recovering. But the year leading to it, I didn’t eat at all. And whatever I ate, I threw up. I weighed 116 pounds when I won. I was skeletal.”

Janell Ross contributed to this report.

Correction: This story has been updated to correct the location of an African American pastor who asked Donald Trump not to make a political speech at her church. The pastor is from Flint, Mich., not Detroit.