Maybe he looked great back in college, but that was 20 years ago. It's not that looks are everything, but they are a part of the courtship/evaluation process; there needs to be a mental and physical connection that will help lead to an emotional connection as you get to know each other.
What she wants: Honesty and sincerity. He might need to lose a few pounds or have imperfections here and there... but so do we all. No one is perfect. She might not want to see all of him on Date #1, but she will eventually want to see it, so keeping things honest is of paramount importance.