We use nationally representative English data to examine regional variations in body mass index (BMI) and waist circumference (WC), and to explore their underlying sources. Beyond our “at the mean” analysis, Shapley decomposition combined with unconditional quantile regression analysis allow us to explore the relative contribution of small-area level proxies of the obesogenic environment as opposed to our set of individual-level characteristics, across the whole adiposity distribution. We find that the regional BMI differences, that are more evident towards the right tails of its distribution, are fully accounted for by the neighbourhood obesogenic environment. The latter exerts an independent contribution to excess adiposity over and above the potential mediating role of individual-level lifestyle and socio-economic position (SEP). Overall, the relative contribution of demographics (age and gender) becomes less evident moving to higher quantiles of the BMI distribution, while that of obesogenic environment, individual-level lifestyle and SEP measures becoming more relevant. The neighbourhood obesogenic environment is also much more relevant in the tails of the WC distribution. The role of the obesogenic environment on excess adiposity is more pronounced for women than men. Overall, our results highlight that policies that aim to tackle excess adiposity should address both people and places.

我们使用具有国家代表性的英语数据来检查体重指数（BMI）和腰围（WC）的区域差异，并探讨其潜在来源。除了我们的“平均”分析之外，Shapley分解与无条件分位数回归分析相结合，使我们能够探索致肥胖性环境的小面积水平代理相对于整个肥胖分布的个人水平特征集的相对贡献。我们发现，区域BMI的差异在其分布的右尾部更为明显，这完全是由邻近的致肥胖环境造成的。后者对过度肥胖有独立的作用，其超出个人水平的生活方式和社会经济地位（SEP）的潜在中介作用。总体，人口统计学（年龄和性别）的相对贡献变得越来越不明显，而转向了更高的BMI分布，而致肥胖环境，个人水平的生活方式和SEP措施的相关性变得越来越重要。在WC分布的尾部，邻近的致肥胖环境也更为重要。女性比男性更容易发现致肥胖环境对肥胖的影响。总体而言，我们的结果表明，旨在解决肥胖症的政策应同时针对人和地方。在WC分布的尾部，邻近的致肥胖环境也更为重要。女性比男性更容易发现致肥胖环境对肥胖的影响。总体而言，我们的结果表明，旨在解决肥胖症的政策应同时针对人和地方。在WC分布的尾部，邻近的致肥胖环境也更为重要。女性比男性更容易发现致肥胖环境对肥胖的影响。总体而言，我们的结果表明，旨在解决肥胖症的政策应同时针对人和地方。