In a campaign video posted by Mrs Clinton on Twitter, Ms Machado claims Mr Trump threatened to take her crown away after she gained weight.
"He was overwhelming. I was very scared of him. He'd yell at me all the time. He'd tell me: 'You look ugly' or 'You look fat'.
"Sometimes he'd 'play' with me and say: 'Hello, Miss Piggy', 'Hello, Miss Housekeeping'."
Mr Trump, she says, then invited reporters to watch her during a work-out session. The clip includes an interview he gave to the media.
"She weighed 118 pounds or 117 pounds (53kg) and she went up to 160 or 170 (72kg to 77kg)," he says. "So this is somebody who likes to eat."
Alicia Machado says: "It was very humiliating. I felt really bad, like a lab rat.
"It had turned into a circus, the joke of 'The Fat Miss Universe'."
She says the episode caused her "a lot of pain" and that afterwards she fell "sick with eating disorders".
"I wouldn't eat, and would still see myself as fat, because a powerful man said so."
In an interview to the Washington Post in 1997, she said: "When I was preparing for Miss Universe, it was an obsession for me to not gain weight.
"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 (52kg) when I won. I was skeletal."
She has now become an American citizen and has vowed to vote for Mrs Clinton.
What does Trump say?
In an interview to Fox News on Tuesday, Mr Trump appeared to defend his remarks.He said Ms Machado was "the worst (Miss Universe) we ever had. The worst. The absolute worst. She was impossible.
"She was the winner, and she gained a massive amount of weight, and it was a real problem... not only that, her attitude.
"And Hillary went back into the years and... found the girl and talked about her like she was Mother Teresa, and it wasn't quite that way, but that's OK. Hillary has to do what she has to do."
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