<p>The uneven distribution of overweight across urban areas represents a form of spatial health inequality. In contrast to Western countries identifying two types of overweight neighbourhoods, neighbourhood type in China may act as a proxy connecting socioeconomic stratification, built environment disparities and overweight, shaped by both institutional and market forces. Despite this complexity, the relationship remains underexplored. This study examines the associations among neighbourhood type, built environment factors, and overweight status, drawing on data from 1,542 adults across 42 urban neighbourhoods in Hebei Province, China. Six logistic regression models were used to assess how obesogenic environmental factors influence overweight and how these effects differ across neighbourhood types. Results show that higher densities of unhealthy food retailers, greater green space, and higher land use mix are associated with an increased risk of being overweight. The influence of the built environment varies by neighbourhood type: land use mix is more impactful in old communities, while food environment and green space are more influential in commodity housing estates. Additionally, gender differences in these associations are observed only among residents of old communities. Although overweight prevalence is high in China, no spatial disparity is observed between the two neighbourhood types. Nonetheless, built environment elements influence overweight in nuanced ways, both in comparison with Western contexts and between China’s old communities and commodity housing estates. This paper offers new insight into how China’s unique institutional residential structure contributes to spatial patterns of overweight through the interaction between built environment elements and residents’ socio-demographic characteristics.</p>