Single-pier, dual-bearing bridges are susceptible to effects such as concrete creep, thermal expansion, and uneven foundation settlement. When combined with eccentric loading from heavy vehicles, these factors collectively can significantly increase the risk of bridge overturning. To address this risk, a comprehensive analysis of the bridge overturning mechanism was conducted. Considering the current limitations of health monitoring in bearing reaction force (BRF) measurement and risk mitigation, an adjustable intelligent bearing based on pressure sensing and self-locking principles was developed. Its mechanical performance was analyzed under the most unfavorable load conditions. To further validate the approach, a specific experimental bridge was used as a case study. The effectiveness of the force measurement and height adjustment functions was evaluated through moving load experiments. The results showed that the force measurement function accurately captured dynamic BRF changes within a precision range of ±0.1% FS and demonstrated high sensitivity to instantaneous impact effects. The height adjustment function achieved a reaction force change of up to 40 kN within the maximum adjustment range of 1.2 mm, significantly improving the load distribution of the bridge. These findings validated the reliability of the proposed intelligent bearing in real-time monitoring and proactive risk adjustment. This effectively overcomes the limitations of existing bearings, which only perform passive monitoring. Overall, it achieves the real-time monitoring of BRF and proactive control of bridge overturning risks.