42 is not too old. You mustn't give up. I was in a similar situation to you, and my health suffered badly, being a batchelor until 40. Now, pushing 50 I've got a wife and two kids, the youngest being a 15 month old girl. She is the light of my (entire) life.
If you have changed in such a way that you may not be attractive, change it back. You can. I did. If you are fat, lose weight. I did (90 lbs). If you are bald, embrace it and shave off the rest of your hair. If you can't attract an American woman (they do tend to be a bit neurotic) go for a foreign bride.
42 is not too old. You have nothing but time.
BS. At 38, I'm realizing that the time is, indeed, limited. If I want a family, and want to be something less than 60 when at least the first kid hits 20, time's a-wastin'. Married for 3 years, yes, it's time to get past the selfish I-wants and she-wants and get going on what the next generation needs.
We die. We have limited time. We have only one shot at this. While one should not move too fast into marriage - waiting past 25 seems about right - don't wait too long lest proper opprotunities pass you by permanently.
Bill